Aetna Wins Best Disease Management Program Award
Disease Management Association of America honors Aetna’s Chronic Heart Failure Program as best disease management program in managed care
HARTFORD, Conn., October 15, 2003 — Aetna (NYSE: ΑET) today announced that it has won The Best Disease Management Program in Managed Care award from the Disease Management Association of America (DMAA). Aetna’s Healthy Outlook Program®, Caring for Chronic Heart Failure (CHF), best matched the DMAA criteria, which included demonstrating an organizational commitment to disease management, employing science in the design and implementation of the program, excellence in implementation, and favorable outcomes that have been measured using carefully designed measurement methodology.
"Living with a chronic health condition is a difficult challenge facing millions of Americans," said William C. Popik, M.D., Aetna’s chief medical officer. "Well-planned disease management programs are starting to demonstrate significant value for both the member and the employer. Our own analysis has shown that members who fully participated in our CHF program for at least six months had significantly improved compliance with an appropriate treatment regimen, fewer ER admissions for heart-failure-related episodes, and shorter hospital admissions. These findings suggest an improvement in quality of life for the member, and potentially an improvement in productivity for the employer."
Aetna’s CHF program was designed and implemented in 1998, and enhancements include the addition of services in 2001 from LifeMasters Supported SelfCare, one of the nation’s leading disease management companies.
Working together, Aetna and LifeMasters are focused on meeting several key goals with the program:
- Improve member health and quality of life by providing tools, educational materials, and nurse coaching and support that results in positive behavioral change.
- Integrate seamlessly with Aetna’s overall patient management strategy.
- Meaningful communication tools and support for physicians to improve adherence with evidence-based clinical guidelines for CHF care.
- Reduce avoidable medical costs.
"Every day, this program helps 30,000 Aetna members with CHF live a better quality of life, feel healthier, and helps them avoid a deterioration in their condition. And it assists their treating physicians by providing these patients with additional support, education and nurse outreach to help them understand and comply with their doctor-prescribed treatment regimen," said Michael Reardon, M.D., head of Aetna’s Member Advantage programs, including disease management. "We are honored to have won this award, but we’re not stopping here. We remain focused on excellent execution and implementation of the program as well as continuous quality improvement so we can build upon the benefits of this program for our members, our network physicians and our employer customers."
Delivering Results
Heart failure affects 4.9 million individuals in the U.S., at an annual cost of $20.2 billion. More than 70 percent of those dollars are spent on hospital and nursing-home care. Patients with CHF have three times as many visits to physicians, twice as many emergency department visits, and more than three times as many inpatient admissions.
However, it has been clearly demonstrated that appropriate drug therapy and close monitoring will reduce mortality and the frequency and duration of hospitalizations for CHF patients. Drivers of improved quality of life and reduced costs include decreases in readmission, increase in the use of ACE inhibitors and beta-blockers, close monitoring and more specialist involvement.
Through its Aetna Integrated Informatics division, Aetna conducted an in-depth analysis of members with CHF in our HMO-based plans. The company found that full participation in the CHF program for at least six months was associated with significantly improved compliance with an appropriate treatment regimen, and lower medical costs. The study showed that participants in the program had significantly shorter lengths of stay for admissions for heart failure, significantly fewer heart-failure-related emergency department visits, and significantly more days supply of ACE inhibitors and beta blockers than members who did not participate for six months.
"We are very proud to be a part of delivering this award-winning program. Working together with Aetna we have set a new benchmark for collaboration between a health plan and a disease management organization," said Christobel Selecky, LifeMasters’ CEO. "This innovative CHF program has produced positive clinical and financial outcomes and, most important, an improvement in the quality of thousands of lives."
Aetna also offers disease management programs for members with diabetes, asthma, coronary artery disease, end-stage renal disease and low back pain.
Aetna is one of the nation’s leading providers of health care, dental, pharmacy, group life, disability and long-term care products, serving more than 13.0 million medical members, 11.3 million dental members, 7.4 million pharmacy members and 11.7 million group insurance customers, as of June 30, 2003. The company has expansive nationwide networks of more than 579,000 health care services providers, including nearly 349,000 primary care and specialist physicians and 3,589 hospitals. For more information about Aetna, please visit the company’s web site at www.aetna.com.
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