Aetna's Provider-Focused Diabetes Pilot

Aetna developed a provider-focused program for African-American and Hispanic diabetic members in a large provider practice in the Dallas area. The program includes the addition of a bilingual diabetic educator and culturally appropriate patient education materials. The success of the pilot will be determined by improving levels of diabetic control and health outcomes of the participants. 

Read the press release to learn more about Aetna's pilot with the Medical Clinic of North Texas (MCNT). 

Beginning Right® Maternity Program

The overall goal of the Beginning Right Maternity Program is to decrease the risk of premature delivery. One element of this program focuses African-American women.

This initiative provides at-risk mothers with education and preterm labor identification services early in pregnancy. 

Members identifying themselves as African American receive a copy of "Generations - A Pregnancy Guide for Women of African Descent." This educational booklet is published by the Black Infant Mortality Reduction Resource Center, an affiliate of the Northern New Jersey Maternal/Child Health Consortium. 

Results showed that African-American women enrolled in the preterm labor program were more likely to have full-term babies than women not enrolled in the program. Since program inception, more than 9,000 African-American women have enrolled in the preterm labor program.

Breast Health Ethnic Disparity Initiative (BHEDI)

Aetna's Breast Health Disparity initiative reaches out to African-American and Hispanic women age 42 and over who have not had a mammogram according to recommended guidelines from the American Cancer Society. Through letters or outreach calls, we provide culturally sensitive information to address individual risk factors and barriers to obtaining this essential screening. Aetna combines claims data with self-reported race and ethnicity data to identify the members for outreach.

The goals of the initiative are as follows:

• Identify African-American and Hispanic/Latina members who have not had annual screening mammograms
• Identify barriers to screening mammograms
• Provide targeted activities to address identified barriers
• Measure impact of initiative on mammogram rates
• Increase rate of screening mammograms

In 2010, more than 11,000 at-risk women were part of the BHEDI program. 

Care Considerations

Care Considerations are clinical alerts sent to physicians and members based on highly respected sources of evidence-based medicine that identify gaps in care, medical errors and quality issues. Aetna continually evaluates the medical literature to identify care considerations appropriate for targeted populations at risk. Examples of Care Considerations for racial and ethnic minorities include:

• Clinical reminders for sickle cell disease in African Americans 
  
• Medication therapy reminder for chronic heart failure in African Americans 
  
• Screening reminder for Asian patients with hepatitis B who have a high risk for liver cancer

Emergency Room (ER) Utilization in Minority Asthmatic Populations 

Aetna has engaged in a pilot to address ER utilization in members of minority populations with asthma. While complications from asthma can be life threatening, even fatal, we know that proper treatment can decrease or prevent these complications and improve quality of life for members with asthma. In addition, proper treatment decreases the waste that leads to excess health care costs.

This initiative uses a combination of culturally appropriate items, including:

• Home-based environmental assessment
• Member educational materials
• Telephonic nurse outreach
• Physician engagement 
  

The pilot's success will be determined by the health outcomes of the patients, including improved medication compliance. The pilot aims to increase the use of patients' asthma controller medications, as well as to increase member visits to their primary care physician and/or asthma specialist. Additionally, the pilot seeks to reduce avoidable asthma-related ER visits and in-patient hospital admissions.

For more information on Aetna's Emergency Room (ER) Utilization Study, read the press release.

Hypertension in African Americans Study

Working in collaboration with Morehouse School of Medicine (MSM) and Health & Technology Vector, Inc., and with partial funding from Sanofi-Aventis, Aetna conducted a randomized control study in 2007 that examined the effectiveness of a hypertension disease management program in attaining and maintaining clinically acceptable blood pressure measurements among hypertensive African-American members.

The Culturally Competent Disease Management Program (CCDMP) was effective in increasing the percentage of members with clinically acceptable blood pressure.

The study was published in April 2010 in the peer-reviewed medical journal, Population Health Management.