New Services to Help UMP and Aetna Public Employees Plan Members Manage their Health.

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Presentation transcript:

New Services to Help UMP and Aetna Public Employees Plan Members Manage their Health

2 Shaping the Future of Healthcare Governor Gregoire’s Five Point Plan –Emphasize evidence-based care –Promote prevention –Manage care for chronic illness better –Create more transparency –Make better use of information technology Improving healthcare quality ultimately reduces healthcare costs for everyone

3 About ActiveHealth Founded by a physician Helps patients and their doctors take full advantage of evidence-based medical knowledge Combines clinical expertise with technology to get the right information to the right doctors and patients at the right time Helps doctors and patients work together more effectively Provides programs that have been proven to improve patient care and reduce healthcare costs

4 Care Considerations - personalized communications to patients and physicians to improve the quality of care ActivePHR - online Personal Health Record Diabetes Coronary Artery Disease/Ischemic Heart Disease Congestive Heart Failure Programs/Services Offered to All UMP/Aetna Enrollees Informed Care Management Telephonic Nurse Coaching for Actives with Certain Chronic Conditions

5 Care Considerations Personal Health Record Health Coaching Active employees, non- Medicare retirees, dependents age 18+ XXX Dependents under age 18 X X* Medicare retirees XX *Minor dependents cannot access ActivePHR directly. However, a parent/guardian will have access to the minor’s PHR with the exception of sensitive diagnoses. Who’s Eligible? UMP and Aetna Public Employees Plan Members

6 Key Program Features Voluntary –Individuals can choose not to participate at any time “Free” to the member –Included with medical benefit Confidential –Information is maintained on ActiveHealth servers –ActiveHealth complies with federal and state laws Consistent –Same programs, processes for UMP and Aetna enrollees

7 Pharmacy PHR Claims Care Considerations: Identify Member- Specific Issues Complete and timely information sharing Personal Health Record CSID Disease Management Nurse assigns follow up items CONFIDENTIAL - May not be copied, reprinted or redistributed without prior written approval. Labs/Screenings How ActiveHealth Makes a Difference

8 Care Consideration Outreach to Members alert to check their PHR “Please log on to your Personal Health Record and review your Alerts. An alert was posted on 8/3/2008 …” Health information is NEVER put in the . Letter mailed to member’s home Calls from nurses Standard part of health coaching Other members may be called on occasion

9 A Quick Look at ActivePHR Member-specific Alerts, including Care Considerations Information from claims and from the member Immunization record, new patient form, emergency wallet card Calendar with reminders Members can give their doctors access

10 Informed Care Management (ICM) Each member has a personal registered nurse –Average of 20 years experience –Family members can request the same nurse Registered dietitian also available to members Process begins with a brief assessment –Information may generate additional Care Considerations Personal plan developed for each member –Education, motivation, support –Help member take an active role in working with their doctor A follow-up letter is sent after each call

11 Communications to Members Targeted for ICM Telephone calls to member’s home –Automated, with the option to opt out and talk to a live person –From a customer service rep who will connect the member to a nurse –Note: In the event an enrollee cannot be reached at home, they may receive a call at work. Informational mailings to member’s home Eligible members can also self-refer to ActiveHealth < 5% of enrollees expected to be targeted

12 Program Launch Strategy Build awareness among plan members before Informed Care Management and Care Consideration outreach begin Key Dates July 7- Intro letter from UMP/Aetna mailed to subscribers’ homes Mid July- Health Counts! Article August 1- Detailed welcome brochure mailed to subscribers’ homes - Information posted on UMP/Aetna member websites Mid August- ICM outreach begins to targeted members - Care Considerations begin mailing to members’ homes

13 ActiveHealth Contact Information for Members beginning August 1, 2008 Informed Care Management (Nurse Coaching) Mon. - Fri. 6:30 am - 8 pm PST Sat. 8 am - 1 pm PST Questions about Care Considerations received by members Mon. - Fri. 8:30 am - 5 pm ET ActivePHR

14 In Review Programs offered –Care Considerations –ActivePHR –Informed Care Management for certain chronic conditions Voluntary No additional cost to the employee Private & confidential Communications to subscribers begin July 7 Programs begin August 1