P romotion. ealth. rogram. Program Overview. Program Goals

Transcription

1 H ealth P Program Overview P romotion rogram 5890 Sawmill Rd, Suite 200 Dublin, Ohio Phone: Fax: The Clinix Health Promotion Program is designed to provide information related to overall health and wellness along with disease prevention and/or disease management along with age specific screening recommendations. The intention is to engage individuals in the process of health promotion before they develop chronic illnesses that have the potential to affect their quality of life. For those individuals with a chronic condition, the focus is to educate the enrollee to be better informed about the management of their condition. Our program is individualized to meet the specific needs of each member. Through frequent contact, intensive education and support, we are able to accomplish the goal of health promotion and wellness. The Centers for Disease Control and Prevention along with the National Institutes of Health have identified specific goals for the health of our population. Through the Healthy People 2010 project, these goals have been promoted throughout the healthcare community. It is our desire to support this project by incorporating the disease specific goals into the Clinix Health Promotion Program. The Health Promotion Program is based on criteria established by the US Preventive Services Task Force, US Department of Health and Human Services, American Lung association, National Jewish Medical and Research Center, American Heart Association, American Academy of Allergy, Asthma and Immunology, American Diabetes Association, and National Institute of health. Clinical goals: Program Goals Empower enrollees to take an active role in his/her own medical management Modify behaviors that affect his/her health status Incorporate a healthy lifestyle that focuses on preventive health activities Financial goals: Improve overall health and wellness and therefore decrease utilization of healthcare resources Minimize missed work days, ER/urgent care visits, and hospital days Educational Goals: Identify factors that impact health status Identify age specific diagnostic screening tests

2 Program Activities 1. The Clinix Health Risk Assessment (HRA) is utilized 2. The HRA is analyzed and risk factors are identified 3. Individual contact with the member to review HRA results and to encourage appropriate follow up 4. Educational materials are made available to enrolled members. These materials cover nutrition, exercise, stress management, and preventive screenings/interventions. Educational materials are from nationally recognized organizations. Web sites are included for enrollees to access for additional education 5. The program is made available to employees and all dependents covered under the health plan. There is no limit to the number of participants and no limit to the number of programs one person can enroll into 6. Education and support to adhere to the established treatment plan is reinforced 7. Subscriptions to disease specific publications are provided for the first year of enrollment 8. Follow up calls are tailored to the needs of the enrollees. There is no limit to the number or length of calls. is an option if member request 9. To obtain other pertinent information on a need to know basis, the primary care physician is contacted for individual cases Optional Activities On site health fairs Clinix can assist in the coordination of an on-site health fair. We will provide the appropriate staff for the number of attendees expected and for the services provided by Clinix. Clinix can assist with the coordination of lab draws or can obtain labs using the cholestech system. On site health in-services Clinix can assist each client to identify areas of interest and the coordination of on site offerings such as Lunch-N- Learn sessions. Self-Care Guide Book Emergency situations/first aid Common health problems Page 2 Health Promotions

3 Program Enrollment Follow up The employer must be the first to introduce the program to their employees, and make them aware that Clinix will be contacting eligible members. Clinix Healthcare will make screening calls to introduce the program to all eligible members. This process is followed by a general mailing to all individuals who have not responded to the screening calls. This mailing reintroduces the program and encourages the individual to call Clinix to discuss the program. At anytime an individual may call Clinix and self enroll. All enrollment is done by a registered nurse. (RN). Follow up calls are made based on the needs of the enrollee. The number and length of calls are not limited. The Clinix nurse will place the call at a time that is convenient for the enrollee. The main focus of the call is to discuss their health status, reinforce their treatment plan, and provide education. The Clinix nurse is a personal wellness coach giving encouragement and information. At anytime, the participant can call Clinix to speak to their personal RN. Reports An Aggregate report of the data collected from the HRA is provided to the client annually. After the first 60 days in the program, a demographic summary of those enrolled in the Health Promotion Program with chronic conditions is presented. Report flexibly meets client needs A clinical report highlighting key data elements for those with chronic conditions is presented at the completion of the first six months in the program and again following the completion of twelve months. Applicable objectives from the Healthy People 2010 Project are included in the reports. This allows the client to benchmark their findings against national data. Page 3 Health Promotions

4 Diabetes Enrollees in the Diabetes Disease Management Program are coached through the process of accomplishing the following goals and objectives: 1. Demonstrates knowledge of blood sugar goals 2. Recognizes symptoms of hypo and hyperglycemia 3. Understands the long-term complications of diabetes 4. Understands the importance of self care 5. Adheres to medication routine as directed by his/her physician 6. Demonstrates a working knowledge of a diabetic diet 7. Understands the role of exercise in glycemic control 8. Understands why specific lab tests are done and the part they play in documenting long term control 9. Verbalizes an understanding of an emergency treatment plan Success Story Diabetes This is a 63 year-old male with Type 2 Diabetes. Enrolled for 10 months Before A1C: 7.3 Weight: 374 Total Cholesterol: 127 After A1C: 6.7 Weight: 356 Total Cholesterol: 121 Cardiac Enrollees in the Cardiac Disease Management Program are coached through the process of accomplishing the following goals and objectives: 1. Recognizes symptoms of CHF 2. Articulates symptoms associated with complications 3. Understands the rationale for managing cholesterol and triglycerides values 4. Demonstrates a working knowledge of a cardiac diet 5. Adheres to medication routine as directed by his/her physician 6. Understands the role of exercise in cardiac health 7. Completes ADL s without shortness of breath or fatigue 8. Verbalizes an understanding of an emergency treatment plan Success Story Cardiac This is a 60 year-old female post angioplasty with stent placement and pacemaker. Enrolled for 10 months. Before BP: 130/70 Weight: 157 Total Cholesterol: 137 Triglycerides: 169 After BP: 100/60 Weight: 154 Total Cholesterol: 116 Triglycerides: 96

5 Asthma/Respiratory Enrollees in the Asthma/Respiratory Disease Management Program are coached through the process of accomplishing the following goals and objectives: 1. Demonstrates a knowledge of their treatment plan for asthma management 2. Recognizes triggers of an asthma episode 3. Adheres to medication routine as directed by his/her physician 4. Demonstrates a working knowledge of proper inhaler use 5. Understands the rationale for making needed environmental changes to control allergens 6. Maintains normal activity levels 7. Prevents chronic and troublesome symptoms 8. Demonstrates a working knowledge of a healthy diet 9. Verbalizes an understanding of an emergency treatment plan Success Story Respiratory 57 year-old female with Diabetes and COPD. Enrolled for eleven Months Before BP: 140/80 Weight: 176 Total Cholesterol: 207 After BP: 120/70 Weight: 170 Total Cholesterol: 174 Weight Management Enrollees in the Weight Management Program are coached through the process of accomplishing the following goals and objectives: 1. Demonstrates a working knowledge of a balanced diet to accomplish weight loss 2. Adheres to a healthy diet in order to maintain desired goal weight 3. Understands the role of exercise in maintaining desired/goal weight 4. Articulates triggers that have led to overeating in the past and is able to verbalize appropriate coping skills to redirect behavior 5. Understands the long-term complications associated with being overweight Success Story Weight Management This is a 44 year-old female, overweight and high cholesterol. Enrolled for 10 months Before Weight: 150 BMI: 28 Total Cholesterol: 285 After Weight: 138 BMI: 26 Total Cholesterol: 143

6 Health Elect Enrollees in the Health Elect Program are coached through the process of accomplishing the following goals and objectives: 1. Accomplishes smoking cessation 2. Improves lab values to acceptable normal range 3. Demonstrates knowledge of healthy nutrition and exercise 4. Maintains BP values within established parameters Success Story Health Elect Program for Hypertension This is a 54 year-old male with hypertension and smoker. Enrolled for 3 months BP: 195/97 Smoker Before BP: 124/74 Non-smoker After Service Advantages Our focus is to work with members directly to enhance knowledge of health care through utilization of our state of the art program. This caring and professional concern allows the member to make a informed decision regarding their health care and improve their quality of life. Advantages of partnering with Clinix Healthcare Registered nurses with clinical expertise in the defined areas of service Live answer phone system with a message center after hours URAC Accreditation Licensed in all states requiring such licensure AT&T Language Line Services Individualized education to meet the specific needs of each enrollee Flexible data reporting 5890 Sawmill Rd, Suite 200 Dublin, Ohio Phone: Fax:

7 Return On Investments (ROI) Although returns will vary, based on the experience of other companies who have implemented wellness programs for their employees, your company should expect a return on investment within the range illustrated below. It can take two or three years to be able to adequately show a ROI from any wellness program. Companies who have implemented these programs are experiencing major benefits -- from lower health care costs and reduced absenteeism, to greater productivity and morale. Many companies are reporting double digit decreases in sick leave, hospital admissions, disability days and per capita workers compensation costs, as a result of their corporate wellness programs. The following chart demonstrates the return per dollar invested for 7 well-known companies who implemented wellness programs. Additional success can be expected when incentives are provided to encourage employee participation in the program. Prevention Programs: Intended to target a large portion of the employee base, the goal is to have an impact on the health of those people who are at most risk to develop chronic conditions. It is also important to not neglect those people who already follow a healthy lifestyle. The goal with this group is to keep them healthy. The goal of a prevention program is to prevent costs before they are incurred. Disease Management: Intended to target a smaller portion of the population. The financial goal is to control the costs associated with poor control of chronic diseases. Return on Investment $7.00 $6.00 $5.52 $5.78 $6.15 Unum Life $5.00 $4.00 $3.00 $3.00 $3.15 $3.90 Pepsi Co Motorola General Mills Equitable Life $2.00 $1.00 $0.00 $1.81 Kennecott Coors

8 H ealth P P romotion rogram 5890 Sawmill Rd, Suite 200 Dublin, Ohio Phone: Fax: Clinix HRA and Sample Report

9 Clinix Connection to Health Health Risk Assessment/ Screening Tool only Gender M F Date of Birth / / Height Weight How would you describe your overall physical health? Good Fair Clinical values: Poor Test Result Date Test Result Date Diabetes/ HA1C Annual Physical NA Total Cholesterol Tetanus Prophylaxis NA HDL // LDL // Flu Shot NA Blood Pressure / Pneumonia Vaccine NA Resting Pulse Triglycerides Bone Density Pap Test Mammogram Colonoscopy Rectal Exam/Hemocult Dental Examination Eye Examination Prostate Exam or PSA 1. Do you consider yourself to be: underweight about the right weight overweight a. Are you interested in a weight management program? Yes No 2. Smoking history a. Are you currently smoking? Yes No b. Did you ever smoke? Yes No c. IF yes, did you stop smoking more than 2 years ago? Yes No 3. Do you use drugs or medication (including prescription drugs), which affect your mood or help you to relax? almost every day sometimes rarely or never 4. How many alcoholic drinks do you usually have per week? none 1 to 6 7 to to When you drive or ride in a car do you wear a seat belt? Yes No 6. CIRCLE if you have a history of ( H ) and/or currently( C ) being treated for? H C Allergies H C Bronchitis/Emphysema H C High Blood Pressure H C Angina H C Depression H C Migraine Headaches H C Arthritis H C Diabetes H C Osteoporosis H C Back Pain H C Heart Problems H C Stroke H C Cancer H C Heartburn /reflux H C Asthma 7. Do you have a bloodline relative with any of the following? 7a. Family history not known Alcoholism Other Cancers High Blood Pressure Breast, Uterine, Prostrate Cancer Glaucoma High Cholesterol Diabetes Heart Problems Stroke 8. How many servings of foods high in fiber, such as whole grains, fresh fruits or vegetables do you eat per day? rarely/never 1-2 servings per day 3-4 servings per day 5-6 servings per day

10 8. How many servings of foods high in cholesterol or fat, such as fatty meat, cheese, fried foods or eggs do you eat per day? rarely/never 1-2 servings per day 3-4 servings per day 5-6 servings per day 9. In an average week, how many times do you engage in physical activity for at least minutes, that is hard enough to make you breathe more heavily, and your heart beat faster? (i.e. running, brisk walking, or heavy labor) less than 1 per week 1-2 times per week 3-5 times per week 11. In general, how satisfied are you with your life? completely satisfied mostly satisfied partly satisfied not satisfied 12. In general, how satisfied are you with your job? completely satisfied mostly satisfied partly satisfied not satisfied 13. Do you have trouble sleeping? Yes No 14. How much pain have you had during the past four weeks? none mild moderate severe 15. How often do you feel tense, anxious, or depressed? often sometimes rarely never 16. In the past year, how many times did you visit the Emergency Room or Urgent Care? Why? 17. In the past year, how many days were you hospitalized? Why? 18. In the past year, how many days of work or school have you missed due to personal illness? work days school days Why? 19. Have you experienced the following symptoms? Nausea Vomiting Bowel changes Frequent bruising Chest tightness Urinary frequency Urinary burning Productive cough Excessive fatigue Dizziness Heart palpitations Short of breath Loss of appetite Excessive thirst Never/Rare Previous Current Date: Name: Address: City State Zip Code Phone: ( )- Area Code/ Employer:

11

12

13

14

15

16