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CDPHP Launches Program to Help Members Manage Disease

Posted on: Monday, 20 February 2006, 03:03 CST

By Tampone, Kevin

Capital District Physicians' Health Plan, Inc. (CDPHP) is launching a new program that gives 215,000 of its members access to a personal health coach.

The program, Health Coach Connection, is designed to help members manage their diseases and health more effectively, says Sheila Hoorwitz, manager of disease management and wellness for CDPHP.

"We're looking to help people improve that self management," Hoorwitz says. "This will improve our members' education process."

The health-coach program could also result in fewer patient admissions to the hospital and fewer surgeries, which drive up health-insurance claims.

On Dec. 8, CDPHP began to provide members with access 24 hours, seven days a week, to health coaches. The health plan contracted with a vendor, Boston-based Health Dialog, to provide the service.

CDPHP declined to release financial details of its multi-year contract with Health Dialog. Albany-based CDPHP covers about 377,000 people in the

Capital District, Central New York, Hudson Valley, and Southern Tier.

About 215,000 CDPHP members are eligible for Health Coach Connection because some of the company's plans, such as those self- funded by employers, elected not to participate, according to the company. Those plans are covered by CDPHP's own, internal disease- management program.

The health coaches can help members with questions ranging from bee stings and prescription drugs to coronary artery disease and diabetes, Hoorwitz says.

Members can call with any health-related questions they have, says Mary Jane Favazza, senior vice president of service delivery for Health Dialog. The first time members call the service, they are connected with a primary health coach. That person becomes their point of contact for all future calls.

Primary coaches give their direct extensions to members and have voicemail. Coaches are available at all hours, but members can always call and leave a message for their primary contact.

"If you have a personal, trusted relationship with someone, that's always better," Favazza says. "We believe that's very important for a service like this to be valuable and successful.

"If you talk to a different person every time, the trust doesn't always come out. People are in tough situations sometimes."

Patients might not be willing to discuss things like problems in the home or financial difficulties related to health care with a total stranger. If they've talked with a coach multiple times, those issues are more likely to come out, Favazza says.

If a caller needs more specialized information, the primary coach can bring in a specialist, such as a dietician or respiratory therapist to answer more specific questions. Patients can talk to those specialists themselves or have their primary coach there through a conference call. Health Dialog is privately held and employs more than 850 people. It serves health plans throughout the United States. It does not disclose its revenue information.

The health-coach program will be especially helpful for people with chronic illnesses and those facing serious, complex health issues, Hoorwitz says. Those people receive outreach letters and phone calls from health coaches to inspire them to have an active role in managing their conditions.

If members don't want to participate in the program they don't have to, Hoorwitz says. Most people do, however, since the service doesn't cost anything extra.

"Most often, people are very receptive," Hoorwitz says. "When they find' out it's free and they can ask anything they want, they usually have tons of questions they want to ask."

Hoorwitz says the program should help improve the overall health of members. For example, coaches can help callers ensure they are taking medications properly and receiving tests and exams they might not have known were necessary.

Health coaches have helped reduce major claims from those with chronic diseases at other health plant; 4 percent to 11 percent, according to Health Dialog.

Among some groups who have used Health Dialog's services, hospital-admission rates have dropped as much as 17 percent and surgeries as much as 40 percent, according to the company.

"We're certainly looking to engage folks with ongoing health problems," Hoorwitz says. "But this is something that can help all of our members. The goal is to get them better educated and more involved in their health."

Copyright Central New York Business Journal Dec 30, 2005

Source: Business Journal - Central New York, The

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