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Medica Introduces Clinic-Based Chronic Care Program

Posted on: Wednesday, 19 December 2007, 12:00 CST

Medica today announced that it has developed a partnership with five clinic systems throughout Minnesota to provide a clinic-based chronic care management program to patients with chronic diseases. The clinic systems are: Fairview Clinics, North Clinic, North Memorial Clinic, St. Mary's Duluth Clinics and Stillwater Medical Group. The program is being rolled out in the fourth quarter of 2007 and the beginning of 2008 and is available to all patients -- not just Medica members -- who receive care at participating clinics.

"Providers have indicated to us that they want to deliver comprehensive care management within the clinic setting and they are well-positioned to accomplish it because they maintain the closest relationship with patients," said Dr. Jim Guyn, Medica medical director for provider relations. "Medica is delighted to partner with these clinic systems because we believe the clinic-based chronic care management program is a huge step in getting the appropriate care to the patients who need them most in the most efficient and effective manner possible."

The clinic-based chronic care management program focuses on the whole person who has or is at risk for a chronic disease, taking into account such things as lifestyle, prevention and physical and behavioral health. Proven behavior change methods are used and each person's level of engagement is determined by their desire to work on changes in behavior that will improve their health or lower their risk of disease.

Medica's clinic-based chronic care management program is designed to address the rising cost of health care and improve health outcomes. People with chronic disease account for 75 percent of the nation's $1.7 trillion spent on health care, according to estimates by the Centers for Disease Control (CDC). The CDC also has found that chronic diseases are among the most preventable of all health problems.

As the staggering cost of health care associated with chronic illness has become apparent, disease management programs offered by health plans have become popular. While they have proven effective, the clinic-based program represents an important shift to bring the management of chronic diseases closer to the point of care. Under the program being announced today, Medica will support these clinic systems in building the capacity to extend their care and management of patients with chronic illness.

Each of the clinic systems will focus on a specific chronic condition that matches with their patient base and the system's ability to deliver chronic care management for those conditions.

For example, North Clinic is developing its program around heart failure patients. The program involves first identifying patients through system-wide referrals from primary care providers and post-hospitalization diagnoses. A registry will then be developed to monitor clinical status and track process and outcome measures. Clinic staff will be encouraged to use evidence-based treatment plans for patients with heart failure and provide care coordination between the clinic and hospital.

Meanwhile, North Clinic providers will work with patients to develop self-management and monitoring tools, including such things as action plans (based on the patient's readiness and ability to make changes) and in-clinic and telephone follow-up to ensure compliance with the plan. North Clinic also will identify and recommend community resources for its patients.

"We are extremely pleased to participate in this chronic-care management program with Medica," said Dr. Cynthia Weisz, medical director at North Clinic. "As providers on the front lines of care, we believe we are in the best position to help patients with these diseases make improvements to their health. The program also supports the concept of a medical home, which North Clinic believes is very important to the ongoing care of its patients."

About Medica

Serving more than 1.3 million members, Medica is a health insurance company headquartered in Minneapolis and active in the Upper Midwest. The non-profit company provides health care coverage in the employer, individual, Medicaid, Medicare and Medicare Part D markets in Minnesota and a growing number of counties in North Dakota, South Dakota and Wisconsin. Medica also offers national network coverage to employers who also have employees outside the Medica regional network.

Source: Business Wire

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