Download
laura jacobus kantor ph d the michigan purchasers health alliance september 21 2006 n.
Skip this Video
Loading SlideShow in 5 Seconds..
Selected Results from Chronic Disease Management and Behavioral Health PowerPoint Presentation
Download Presentation
Selected Results from Chronic Disease Management and Behavioral Health

Selected Results from Chronic Disease Management and Behavioral Health

120 Vues Download Presentation
Télécharger la présentation

Selected Results from Chronic Disease Management and Behavioral Health

- - - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript

  1. Laura Jacobus-Kantor, Ph.D. The Michigan Purchasers Health AllianceSeptember 21, 2006 Selected Results from Chronic Disease Management and Behavioral Health

  2. Ensuring Solutions to Alcohol Problems • Located at George Washington University Medical Center • Funded by The Pew Charitable Trusts • Goal: Improving access to alcohol treatment • How: Providing research-based materials through targeted outreach to business leaders, policy makers and advocates • www.ensuringsolutions.org

  3. National Business Coalition on Health (NBCH) & eValue8 • More than 80 state and regional business coalitions made up of 10,000 employer members nationwide employing over 34 million covered lives • eValue8 RFI is a uniform, annual assessment of the quality of care for a range of health concerns provided by health plans to employees • Survey conducted by businesses for business – purchasing, accountability, incentives and penalties

  4. 2003 eValue8 Participating Plans

  5. 2006 eValue8 Participating Plans Key: Participating States

  6. Aetna HMO Aetna PPO Blue Care Network HMO BCBS PPO Care Choices HMO Care Choices PPO HAP HMO HAP PPO Health Plus HMO Humana PPO M-Care HMO Physicians Health Plan HMO Physicians Health Plan South MI HMO Priority Health HMO Michigan Plans Surveyed in 2006

  7. Chronic Disease Management

  8. HEDIS Trends: Asthma- Appropriate Medication

  9. HEDIS Trends: Cardiovascular 2002-2006

  10. HEDIS Trends: Diabetes 2002-2006

  11. Asthma Disease Management

  12. WhoHas Alcohol Problems? • 11.1% of full-time workers ages 18 – 49 • Approximately 12.3% of MI workers • Twice as many men (13.7%) as women (7.4%) • Prevalence by age: • 18-25(18.9%) • 26-34(12.5%) • 34-49(7.8%)

  13. Here is the Problem: Source: Office of Applied Studies. (2004). Results from the 2003 National Survey on Drug Use and Health: National findings. Rockville, MD: Substance Abuse and Mental Health Services Administration.

  14. Problem Drinking Causes Disease and Injury

  15. How do alcohol problems cost businesses? • Lower productivity • Lost workdays • Extra health care use • Other costs: • Workers compensation and disability • Accidents and damage • Turnover and worker replacement • Diverted supervisory and co-worker time • Workplace friction • Family disruption

  16. Spending by Insurers 1991-2001 Chart Source, SAMHSA, 2005

  17. Spending by Insurance Source 1991-2001 Chart Source, SAMHSA, 2005

  18. Current State of Treatment • Employment-based health benefits • treat addiction as if it were an acute illness or willful bad behavior • General medical system • unprepared and un-paid to identify or treat alcohol problems early • Specialty substance use treatment system • hampered by low insurance reimbursement, acute care model • Many people with alcohol problems do not want the primary treatment goal offered: • abstinence

  19. Behavioral Health Overview

  20. Alcohol Disease Management

  21. 8% 92% Estimated Percentage of Plan Members with an Alcohol Problem Recent estimates suggest that almost 8% of the US population has an alcohol problem

  22. How many get Identified? 8% Less than 1% of Michigan members are identified. 92%

  23. 9% 91% Estimated Percentage of Plan Members with Depression Recent estimates suggest that almost 9% of the US population has a major depressive disorder

  24. How many get Identified? 9% 4.3% of Michigan members are identified. 91%

  25. Identification Rates for Other Health Conditions

  26. Alcohol Screening Instruments for Primary Care Providers

  27. Alcohol Screening Instruments for Behavioral Health Providers

  28. DepressionHEDIS Collected 2003-2006

  29. Behavioral Health Comparisons • Disparities between behavioral health and non-behavioral health are evident: • Identification rates • Use of data elements to identify affected members • Rate of communication between plans • Rate of activities that encourage follow-up with identified or high-risk individuals

  30. What more can be done? • Employee Assistance Programs • Work with other businesses and health care providers • Use EAP and Health Plan data to build the case for the effectiveness of employment-based alcohol treatment in business terms: • Avoidable health care costs • Avoidable productivity losses • Avoidable absenteeism

  31. What Businesses Can Do to Make Their Workplaces Safer, Healthier and More Productive • Comprehensive Health Insurance Benefits • Average cost of upgrading is around $5 per beneficiary per month • Equitable co-pays, deductibles, limits. Co-pays less than $10/session. • It is being done! • Managing health plan benefits • National Business Coalition on Health’s eValu8 RFI at www.nbch.org • Confidential screening and brief intervention • Encourage primary care screening and treatment • Monitoring utilization and outcomes

  32. Looking forward: The 2007 eValue8 RFI • Investigate eValue8 scales-both within and between sections: • Section scales • Summary scales • eValue8 total scale • What are the properties of these scales? Do they accurately measure what we want them to? • Which items do not contribute any unique variance to scales and can be eliminated from future versions of the RFI?