If you have Type 1 diabetes, you need to monitor before meals and at bedtime at least. Type 2 diabetes, you can get away with a couple of tests daily and …
Healthy Numbers Diabetes Disease Management
Diabetes is one of the most serious health problems 41 facing our country with prevalence increasing at Percent of working men and women with epidemic proportions According to the American undiagnosed diabetes Diabetes Association, 182 million people in the United States have diabetes Every year, another 13 15,050 million aged 20 and older people who make up the Annual cost of a diabetes complication, including American workforce are diagnosed with the disease medical and disability Often, people with diabetes do not realize the seriousness of their condition until overt and costly 24 complications present themselves, such as heart Percent of workers who are limited in their ability disease, high blood pressure, kidney disease, to work because of gangrene, amputation and blindness diabetes For plan sponsors, the costs related to diabetes are staggering Medical and disability costs associated with diabetes complications for a single member can amount to more than 15,050 annually Multiply this by the number of members in your plan with diabetes up to 10 percent of the total covered population and the financial impact becomes clear
K N O
W I N G V S D O I N G It doesnt have to be this way Diabetes, more than any other chronic illness, can be managed By making healthy lifestyle changes, individuals with diabetes can dramatically improve their quality of life and reduce the likelihood of diabetes complications Cardium Health provides diabetes disease management to Taft-Hartley, multiple employer and other plan sponsors With a people-centered, integrated and multi-disciplinary approach, we help individuals move from knowing what they should do to improve their health to actually doing it Through frequent one-on-one counseling, participants learn to make the lifestyle changes they need to manage their diabetes and reduce their risk of complications They learn how to monitor their blood sugar every day and balance their intake of carbohydrates They learn how to shop and prepare balanced meals Over time, they develop healthy eating habits to lower their cholesterol and control their blood sugar levels
DIABETES
DISEASE
MANAGEMENT
They discover exercise programs they enjoy and develop routines that contribute to successful weight management Plan sponsors that provide a diabetes disease management program for their
members realize demonstrated dollar-for-dollar savings by reducing the number of diabetes complications
R E A L C A R I N G / R E A L C H A N G E The single most important thing for a person with diabetes to understand is the importance of their numbers Daily blood values, HbA1c levels, lipids and blood pressure readings provide a window to see how well the condition is being managed Too often, however, people dont understand why the numbers are important or how diet and exercise impact their condition At Cardium Health, our multi-disciplinary counseling model connects with people at their level of understanding We fill the communication gap between participants and their doctors to answer questions that people are too embarrassed or afraid to ask We have in-house certified diabetes educators cdes who explain what the numbers mean and how to count carbs Also, we recognize the tremendous mental stress that comes with having a chronic disease There is no cure for diabetes To help participants find the will and determination to adapt healthy lifestyle behaviors, we focus on the positive and give people permission to enjoy the foods they like in moderation We help them create
supportive home environments and teach them that having good nutrition isnt a diet
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Diabetes Program Overview
Program Objectives Clinical Interventions
Disease-specific education Cost Reduction Reduce diabetes complications by 50 Clinical Quality Hemoglobin A1c 70 Reduce total cholesterol, LDL cholesterol, triglycerides; increase HDL cholesterol Reduce blood pressure Achieve targeted Body Mass Index BMI Increase physical activity Eliminate tobacco dependency Medication comprehension and compliance Self-management education - monitoring and symptom recognition of blood glucose levels Compliance with physician plan of care Choles 
terol blood pressure goals Nutrition education - carbohydrate counting/meal mgmt Exercise program Stress management Tobacco cessation
PSS_PS_MH_DB_09/06
A Participant Scenario
At Cardium Health, the participant is at the center of all that we do Follow the success of a real life participant with comorbid chronic conditions to understand how our program works to encourage healthier lives and happier members
Process Steps
Cardium Health Disease Management Program Components
1
Identification
Leverage multiple data sources to
provide effective analyses
Profile: Female; 51 years old; 53; 147 Medical claims: diabetes mellitus, hypertension, hypercholesteremia Pharmacy claims: blood glucose regulators Lab values: Hemoglobin A1c, triglycerides, cholesterol
2
Enrollment
High-touch, on-going outreach to all identified candidates
Outreach Coordinator gathers additional demographic information, confirms diagnosis and schedules 30-minute assessment call with Senior Health Management Clinician
3
Assessment
Proven algorithm to match the level of participation with the appropriate level of care
Senior Health Management Clinician conducts assessment based on clinical risk, readiness to change and health literacy, and identifies primary health goal to lower cholesterol and lose weight Assigned to Intensive Personalized Counseling IPC with telephonic bi-monthly intervention Certified Diabetes Educator CDE as primary health coach PHC
4
Behavior Change
Real caring for the whole person
Participant discloses that she is not testing her blood sugars regularly and has not seen her doctor in six months CDE clinician addresses fears of diabetes complications and educates on blood sugar testing and self-care Upon
sufficient control of blood sugars, PHC recognizes participant is ready for exercise program for support in weight and blood sugar management Referral made to exercise physiologist EP, a Cardium Health specialty health coach SHC
5
Behavior Maintenance
Participant self-management
With support from PHC, participant monitors blood glucose and participates in bi-annual doctor visits and healthcare choices Participant continues with periodic EP consults to use exercise to help overcome stress from everyday life events
6
Results
All-inclusive clinical measurements with proven and verifiable financial results
Lowered total cholesterol by 15, lowered LDL bad cholesterol by 28 and raised HDL good cholesterol by 24 Reduced HbA1c levels by 1 percentage point Lost 18 lbs or 10 of body weight Exercising 4x/week, 30 min/day Graduation to self-management
DIABETES
DISEASE
MANAGEMENT
With this understanding, the motivation to adapt healthy behaviors becomes something that people want to do, not something that they have to do And that leads to lasting change Our Standards of Care for diabetes disease management adhere to evidencebased guidelines published by the American Association of
Clinical Endocrinologists in conjunction with the American Diabetes Association and the National Cholesterol Education Program
REAL ADVANTAGES Cardium Healths diabetes disease management program have a proven 50 reduction in the incidence of diabetes complications Monitoring and measurement is enabled by DM TrackSM, the Cardium Health proprietary data management system It coordinates multidisciplinary health interventions, provides treatment guidelines, tracks participant progress, and generates customized outcome reports Average three-year roi results are greater than 250
Clinical Financial Measures
Measurement Report Frequency Results
Active participation Gender distribution Age distribution Member relations HbA1c readings Physical activity Cholesterol levels Smoking cessation quit rate Comorbid conditions Participant satisfaction Complication rate Number of averted diabetes complications Return on Investment
monthly /annually
8090 engagement
20 Batterson Park Road
Enrollment Clinical Financial
quarterly and/or annually
99 participant satisfaction rate of good to excellent
Year one ROI: 150 annually Year two beyond: compounding returns
Farmington, CT 06032
860677
8900
wwwcardiumhealthcom
Source:hypertensionfoundation.org
