About 10 years ago, UofL Physicians and Get Healthy Now created the Health Management Services program, aimed at helping employees and retirees enrolled in UofL’s insurance program better manage their pharmacy needs. Last year, that program evolved to become more of a medically-driven model versus just having a pharmaceutical focus.
There are five conditions that qualify for eligibility in the program: Diabetes, high blood pressure, high cholesterol, COPD and asthma. As part of this update, GHN brought two ULP employees on site – Ketia Zuckschwerdt, RN, who is the program manager, and Mary Corbett, APRN – to work directly with participants throughout their care process.
“There is nobody better than a nurse and a nurse practitioner to understand the needs of a patient and triage them where they need to go. That’s why this program is so great – they can point them in the right direction. It’s a unique program and a dynamic partnership,” said Patricia Benson, AVP for Health, Wellness and Disease Management. “Mary and Ketia are able to serve as a nurse, health coach, pharmacy consultant and care navigator all rolled into one.”
Zuckschwerdt said the program’s incentives include cost savings.
“There is a money-saving incentive because you’re automatically eligible for the $40-a-month incentive with HR. There is also a pharmacy incentive – generic medications are free for the program they’re enrolled in and there are also cost savings for higher-cost medications,” she said. “Insulin is typically $60 to $100 a month. In our program, they would pay $20.”
More importantly, however, there is a holistic care incentive with an objective of helping participants live healthier lives.
“We are doing care management, setting goals and following up with them, and working with their physicians,” Zuckschwerdt said. “There’s a big accountability piece to this so we can make sure they’re doing what they said they were going to do. It’s a wrap-your-arms-around-you approach and it is very high touch and personalized.”
Corbett said this approach is necessary to navigate the health care system complexities that may deter people from succeeding in getting healthier.
“Many people have multiple providers and specialists and they’re prescribing different things. Things are segmented and we’re trying to break down those silos,” Corbett said. “We’re communicating with their primary physician; not taking over, but streamlining so we can help them be their own best health advocates.”
Since the program changed to become more holistic last year, there has been a reduction in diabetic A1C results. The team has also received positive feedback from participants.
“In the past year I have experienced some odd medical issues and I have particularly appreciated how the staff has intervened on my behalf with physicians, often obtaining test results before I could and making certain I understood the doctors’ recommendations,” one participant wrote. “The folks with the program have been with me through all the ups and downs, and their assistance navigating what can often be a complex healthcare system has been invaluable. All of this has been in addition to the routine contacts and consistent follow-up as I seek to be the healthiest person – and UofL employee – I can be.”
In order to be as accessible as they can, the Health Management Services team spends three days a week at the GHN center and twice a week on the HSC campus (401 E. Chestnut St.). They also take stay open later on Wednesdays and take lunch-hour appointments.
“Some people don’t enroll because of the time factor and we’re trying to eliminate that barrier,” Corbett said.
The team said the time commitment may also deter some people, but Zuckschwerdt said that does not mean the program is stringent.
“We’re trying to engage participants to be more active and sometimes that means walking or chair yoga. We’re trying to meet them where they are. This is a judgement-free zone,” she said. “We’re also trying to help employees be aware of all of the resources available on campus, outside of this program – things like eating awareness training, the Employee Assistance Program and the Depression Center.”
“Our biggest goal is to make sure people are advocates of their own health. That is going to help them with their productivity and presenteeism, focus and stress management,” Zuckschwerdt said. “We want to help them be their best self.”
To find out whether or not you qualify for the Health Management Services program, a brief lifestyle assessment needs to be completed that considers biological, social and psychological issues related to your condition. The team will then work with your health care partner to develop an individualized program with realistic goals and expectations, taking into consideration your health, lifestyle, support system and schedule demands. For more information, call 502-588-0770 or send an email to email@example.com.
Photo provided by Creative Commons.