Physician engagement makes the difference.
ALLENTOWN, Pa., Feb. 24 /PRNewswire/ -- Business owners throughout eastern Pennsylvania are experiencing something most companies in America covet: reduced usage of critical health care services through increased management of disease and use of wellness programs by employees. The strategy is a practical approach that promotes the power of the physician-patient relationship in a methodical way. Less absences and more productivity are the benefit to business.
Valley Preferred's physician network creates the means to clinically integrate meaningful data for the benefit of providers, health insurance companies, employers and patients. Affordable, flexible health plan options offered to businesses from several large health insurance companies increase choice; health management does the rest by surveying employee populations and instituting rigorous mechanisms to consistently improve physician and patient performance. "Care for chronic disease and ideally, overall patient health, is improved," says Chris Lewis, Valley Preferred's clinical program administrator. "The care system is reduced through wellness education."
Several Valley Preferred client populations were studied. These isolated populations, each diagnosed with similar chronic conditions, showed remarkable results after disease management programs were implemented and monitored (see end of this news release for data).
"We are seeing tangible improvements, one patient at a time," says Gregory Kile, executive director and CEO of Valley Preferred. "We are confident that in the years ahead we will be able to expand these efforts with more to show. It can be an exciting time in health care if we learn how to implement best practices and reduce costs through better alignments throughout the provider system."
From 2005 to 2006, reduced medical needs were achieved through a 72 percent decrease in hospital admissions; 77 percent decrease in hospital days; and a 42 percent decrease in ER visits. Equally important, and a related health benefit, was the 48 percent decrease in the number of absences and 57 percent decrease in number of days absent on the job. These results have become the ideal because the chronic diseases that consume more than 70 percent of health care costs [Source: Institute of Medicine, www.iom.edu] have been actively targeted for prevention and improved care by the 3,600 physicians affiliated with Valley Preferred. Those chronic diseases are asthma, congestive heart failure, diabetes, high cholesterol, hypertension and vascular disease.
Valley Preferred offers health management programs for enrollees with chronic conditions. Key elements of the program are utilization review, case management, disease management, and health education and wellness programs. These programs are tailored to each employer's needs and include on-site health and wellness education, corporate health fairs, health seminars, employee assistance programs, health screenings and health awareness profiles. This preventive focus makes the difference by improving health among member populations.
"In today's world, we cannot build a direct link from controlling disease and promoting health management to less cost, but we can lessen the dependence on health care," says Jack Lenhart, M.D., Valley Preferred's Medical Director. "We feel strongly that we are 'lifting all boats,' including quality of care, and quality of life. There is an epidemic of increasing chronic disease out there and better disease management and prevention are the best practices that yield the most positive results."
"Valley Preferred's physicians are engaged in a self-auditing program that measures outcomes on a per patient basis," explains Dr. Lenhart. "Each physician reviews and records his or her own outcomes on chart audit forms provided by Valley Preferred. These documents are reviewed by a panel of Valley Preferred network physicians and measured against national peer standards for a determination of performance by both the physician and the practice." Through collaboration with physicians and practices, Valley Preferred has achieved physician participation rates in the high 90 percent range.
"Our program is fully intended to affect the behavior of both physicians and the employees of Valley Preferred clients," continues Dr. Lenhart. "The goal of the program is to impact positively on the value of care."
"As health care costs continue to rise, we must help people live healthier lives, and this responsibility lies with all of us - consumers, medical professionals, health insurance providers and employers," says Gregory Kile, executive director and CEO of Valley Preferred. "Our payer partners--23 contracted health insurance companies who work with us to make a difference--understand that better overall community health results can only be improved by working closely with the medical community. Our disease management and wellness programs are the core strategies utilized by our physicians and employers to make a significant difference for patients every day."
Employers may choose from several health benefit plan designs including offering health savings accounts (HSAs) and health reimbursement accounts (HRAs). Also, employees have the lowest overall out-of pocket expenses when accessing 18 hospitals throughout 11 counties in eastern Pennsylvania and more than 3,600 physicians and health care professionals featured in the Valley Preferred network. Enrollees realize out-of-pocket cost savings by seeking care within this Eastern Pennsylvania network.
"I enjoy Valley Preferred's spirit of innovation, their ability to think outside the box," notes Thomas Pappas, president and CEO of UnitedHealthcare of Pennsylvania, one of Valley Preferred payer partners. "Take their disease management program, for example. It's aimed at the overall wellness of patients. It's absolutely proactive and intent on improving health before a medical crisis occurs. Too many disease management programs are after the fact, when it's harder to handle costs. This is Valley Preferred's emphasis on innovation at work and we think it keeps them poised to continuously look for additional breakthroughs in health care management."
About Valley Preferred
Valley Preferred is Pennsylvania's leading provider-owned, preferred provider organization. In partnership with 3,600 community-based doctors and 18 hospitals, Valley Preferred connects local businesses and individuals with contracted health insurance companies. Valley Preferred's corporate philosophy is reflected in its brand performance promise of "Care Beyond the Coverage." Through BeneFIT, its suite of custom health and wellness programs, Valley Preferred promotes healthier lifestyles for company employees and a culture of wellness in the workplace. For more information, visit www.valleypreferred.com.
Examples of Valley Preferred Disease Management Outcomes 2007
After completion of disease management programs
36% improvement in knowledge of HbA1C.
83% monitored finger stick blood sugars.
72% had micro albumins checked regularly.
84% had an annual eye exam by an ophthalmologist.
57% increase in exercise.
0 work days were missed.
43% increase in diet compliance.
43% increase in exercise.
100% patients take their medication as directed by their physician.
50% patients use medication/disease identification.
38% less work days missed.
94% of patients have their blood pressure checked regularly.
52% improvement in monitoring and reporting peak flow meter readings.
34% increase in exercise.
87% decrease in work/school days missed.
150% increase in use of medication/disease identification.
95% of patients know their blood pressure.
32% increase in diet compliance.
39% increase in exercise.
93% patients take their medication as directed by their physician.
0 work days were missed.
Physician Self-Audit Data Capture
60% increase in adult asthma audits.
60% increase in pediatric asthma audits.
28% increase in diabetic audits.
Physician Self-Audits Returned
95% return rate for all physicians.
40% increase in physician incentives for participation in the Quality Improvement Program.
|SOURCE Valley Preferred|
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