Cincinnati Pioneers “Health Coaching” Program in Partnership with Kroger

by LAS

The City of Cincinnati partnered with Kroger and Anthem Blue Cross Blue Shield of Ohio to run a pilot program for 600 employees and retirees. The programs offer “health coaches” in Heart Healthy Coaching and Diabetes Coaching for some amazing results.

The enrollees were compared to a control group and saw statistically significant results. Enrollees were better at adhering to medications, and blood pressure dropped 4 percent. Kroger's clinical development manager stated that just a 2 percent drop in BP can mean a 10 percent drop in stroke deaths.

Emergency room visits dropped 40 percent with the group in the Heart Health program, compared to the general population. Participants in the Diabetes Coaching program saw an astonishing 90 percent drop in cardiovascular-related ER visits.

Those who did not participate in the program saw total cardiovascular medical costs triple, compared to a drop of 11 percent for the enrollees.

A carrot was held out to participants in the form of deep discounts on their medications as long as they were active in the coaching program. Co-pays were waived.

The first visit with a coach typically lasted an hour, when the patient declared what their goals were, and the coach started to guide them through the kinds of decisions they were making.

Many times, an enrollee would meet with a dietician who would walk the participant through the grocery aisle and help her decode food labels so she could make smarter choices. Sometimes the pharmacist is the coach for someone who has several medications or has questions or concerns.

As of 2012, Kroger was exploring whether it could expand the program to other chronic conditions such as asthma or chronic obstructive pulmonary disease. Kroger rolled out the program to all 17 of its Cincinnati-area stores. Meantime, the City of Cincinnati is looking for other claims and pharmacy data that could show whether the program is succeeding or not, and by how much. 

Telemedicine Cutting Costs of Health-care While Improving Outcomes

by LAS

The innovation of offering telemedicine – where patients contact their doctors by phone, email or online – is not only helping shave the cost of health-care but is also helping patients manage ongoing health problems more successfully.

Employers and insurers are both hopeful that telemedicine will potentially keep more patients out of the emergency rooms who do not need that level of care.

Often patients go the ER because they have no other options, either they have no insurance or no local urgent care clinic or the clinic is closed at that hour that they need it. So telemedicine is really offering a medical advice service that is on-call 24/7.

It may shock you to learn that in 2009, there were 136 MILLION emergency room visits, and that at least 20 percent (and by some measures as much as three-quarters of them) could have been properly treated either in a clinic by their primary-care provider or in an urgent care facility. Given that the average ER visit costs at least $1,400, channeling those visits into other options has a high priority.

The good news is that telemedicine is getting rave reviews from users, never mind the insurers. Upwards of 90 percent of patients who used telemedicine gave it a positive approval rating.

One such telemedicine provider is STAT Doctors in the Scottsdale, Arizona area. Scottsdale began offering the telemedicine option and began seeing benefits: lower costs of course, but also decreased absenteeism.

Many employers offer call-a-nurse services as part of their healthcare plan. If more employees took advantage of that service, maybe a true form of telemedicine with access to physician consultations would be deployed.

Looking ahead, applications designed for wireless home-based health care services and advice is expected to grow from a $304 million-dollar market to $4.4 BILLION by the end of this year.