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Integrating Self-Direction with Provider Support

T H E A C T I V A T E D P A T I E N T. Integrating Self-Direction with Provider Support. RESULTS. Shirley Grey RN MSN. Outcomes: Diabetes. XX CSI. Low-Income Latinos— Sanofi Aventis. COMPREHENSIVE PROGRAM

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Integrating Self-Direction with Provider Support

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  1. T H E A C T I V A T E D P A T I E N T Integrating Self-Direction with Provider Support RESULTS Shirley Grey RN MSN

  2. Outcomes: Diabetes XX CSI Low-Income Latinos—Sanofi Aventis • COMPREHENSIVE PROGRAM • Ethnographic ResearchPatients at home and in doctor appointments • SelfCareKit • IVR and Dashboard • Continuing Medical EducationThree sessions in three cities BEFORE AFTER 9.3 8.7 Average A1c score after SIX months 99.7% Confidence Level 1 5 5 0 B a r c l a y B l v d B u f f a l o G r o v e , I L

  3. Patient Adherence Results: Heart Failure Suburban Medical Center DM program had failed Multiplied compliance rates BEFOREAFTER BEFOREAFTER IMPROVEMENT 185% 27% 77% Weighing Daily Taking Blood Pressure Medication Compliance 86% 514% 14% 59% 14% 321% • Data collected from each group at 6 months • Study designed & conducted by hospital staff EVIDENCE: MORE EFFECTIVE AT ENGAGEMENT 1 5 5 0 B a r c l a y B l v d B u f f a l o G r o v e , I L

  4. Evidence It Works: LOWER CLAIMS COST Challenge: CMS said, "Truckers are the most difficult employees to influence for healthy change.” BETTER SCORES Challenge: Employer said, “We only brought 12% of our hypertensives into normal range after a year of live coaching” We took them on in Illinois! We took them on in South Carolina! Outcome:For every $1 invested, the company saved $1.79--to our knowledge, the first trucker health success! Outcome: 88% of employees reduced their BP scores below the threshold in six months! BEFORE AFTER 6% 88% Over 140/90 88% Below 140/80 12% Clinic confirmed BP after six months Increased medication compliance EVIDENCE SELF REPORTING IS RELIABLE

  5. Evidence Our Program Works: Asthma Medical Center NJ previously used instructions from the American Lung Association OutcomeAdvantage program more than doubled the medication compliance rate EVIDENCE CLINCAL ACCURACY IS NOT ADEQUATE COMMUNICATION Before After Persistence 6 mo44% Readmissions 16% Use of the ER 26% 95% 0 7.4% 1 5 5 0 B a r c l a y B l v d B u f f a l o G r o v e , I L

  6. Reduce 30-day Heart FailureReadmission Rates BEFOREAFTER REDUCED BY BEFORE AFTER 38% 54% 34% 74% 72% 73% 38% 100% St. Joseph, Lexington KY St. Joseph, Elgin IL NWC, ArlingtonHts. ILDRG 127 ONLY NWC, Arlington Hts. IL ALL CHF-RELATED DRGs Aurora, Milwaukee WI Great Plains, ElkCity OK VA, AnnArbor MI Mercy Hospital, Chicago IL 6.4% 4.0% 38% 16.7% 7.7% 54% 13.2% 8.7% 34% 23.4% 6.9% 74% 22.2% 6.3% 72% 8.6% 2.2% 73% 54.5% 33.3% 38% At Mercy only: N = insufficient for highest level of statistical significance, but indicative, especially given overall trend >28% 0%

  7. Results: Satisfaction 5-year kit average = 96% Press Ganey 5-year average = 72% “Did the program help you manage your condition?” Hypertension Yes – 94.9% No – 2.9% Diabetes Yes – 93.6% No – 6.4% CAD Yes –100% Heart Failure Yes – 97.3% No – 1.8% Asthma Yes – 92.5% No – 2.5% UPMC Health Plan 1 5 5 0 B a r c l a y B l v d B u f f a l o G r o v e , I L

  8. FINANCIAL RESULTS: LONG TERM ROI TESTIMONY TO THE NEVADA STATE LEGISLATURE RE: KITS AND CONNECTION PROGRAM “After 24 months, for 712 participants, total medical costs were 23% lower than the baseline year Blood pressure, cholesterol, and blood sugar improved more than 85% ER visits decreased by 16% and hospital days decreased by 54% There were substantial reductions in imaging services (-35%), procedure services (-10%), and average prescription costs per member (-18%). Physician office visits increased by 19%. The net savings at two years exceeded $56 PMPM Members had 30% lower out-of-pocket cost comparedto the alternate PPO plan.” 1 5 5 0 B a r c l a y B l v d B u f f a l o G r o v e , I L C O N F I D E N T A L 2 0 1 2

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