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Integrated Disease Management at HealthPartners. Health Care Transformation Task Force Meeting August 16, 2007 N. Marcus Thygeson, MD Associate Medical Director, and VP Consumer Health Solutions HealthPartners. Integrated Disease Management Strategies.
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Integrated Disease Management at HealthPartners Health Care Transformation Task Force Meeting August 16, 2007 N. Marcus Thygeson, MD Associate Medical Director, and VP Consumer Health Solutions HealthPartners
Integrated Disease Management Strategies • Member engagement (the traditional approach) • Provider engagement • Pay for performance • Select networks (centers of excellence)
Partnering with Providers Focus Publicly Report Results CI Report, MNCM Agree on Best CareICSI Support ImprovementRegistries, ICSI, public policy Measure What’s Important Composites, Outcomes Align Incentives PFP, Compare Peers, Tier Set a Target‘Aim High’
The Power of Pay for PerformanceImproving Diabetes Care 2005 Targets 25% Excellent 30% Superior BP < 130/80, Daily Aspirin Use, LDL < 100, A1c ≤ 7, Non Smoker
Coronary Artery DiseaseManaging All Risk Factors 2005 Targets 55% Excellent 60% Superior BP < 140/90, Daily Aspirin Use, LDL < 100, Non Smoker
Improving Depression Care • Thorough diagnosis • Meets DSM-IV • Monitoring response to treatment • Treated effectively • Meds for 6 mos • Good Access
Disease Management Improves Optimal Care (BP<130/80, LDL<100, A1c<7.0, No Tobacco, and 1 Aspirin a day)
Other Disease Management Results • Best Heart Failure results in the U.S. • On average, 6.4% of members participate in one of our programs. • Participation = actively involved, not just getting some information in the mail. • ROI 2:1 • Decreased complications, including heart attacks, amputations, and blindness.
Estimated Savings • HealthPartners savings estimation methodology validated by external expert • Average Disease Management ROI = 2:1 • Study with David Cutler estimated savings from pay for performance through 2002 • Diabetes: > $18 PMPM per patient • Coronary Artery Disease: > $54 PMPM per patient
Summary • Effective pay for performance and disease management programs • Improve patient care • Enhance health • Save money