For chronic care try turning your employer

If you catch a 133 million U.S. with a chronic disease like diabetes, asthma or heart disease, where do you turn to help manage your condition?

Your employer may seem an unlikely choice. Chronic diseases account for 25 percent of all medical costs, studies show, and an employee of a long illness can result in higher healthcare costs and declining productivity in the enterprise bean counters.

Yet, many companies have realized that it makes economic sense to help improve the health of workers who are the biggest users of medical services.

Today, almost every big firm offers a kind of program long-term care. But the supply can vary considerably, said Dr. Harlan Levine, a director at consulting firm Towers advantages Watson specializes in chronic care management. And for many workers already struggling with their own medical decisions, choosing the new location may seem daunting.

Some companies contract with their insurer or an outside vendor to have a nurse calls sometimes employees with chronic diseases. These programs can do little more than remind a diabetic to get a routine blood test or request an asthmatic, so she takes her medication.

In most programs, however, employees receive assistance through coordination of care between specialists and monitoring requirements, and a dedicated specialist care can solve small problems before they become health crises at hand whole.

Recently, Boeing has completed a successful test program in which employees with chronic diseases have been invited to participate in what is called a program of medical services at home.

Specially trained nurses were available to employees by phone and e-mail about 24 hours a day. They worked one-on-one with patients to monitor their conditions and treatments and help to make the necessary lifestyle adjustments to stay healthy.

The result? Boeing has seen a reduction of 20 per cent of health care costs per member in the program, according to Theresa Helle, head of the testing program. Patients have better and avoid costly emergency room visits, hospitalizations and other major medical events.

A Boeing engineer, Doug McClaren, 54, has signed to assist in the management of a long-standing lung condition. He has been interviewed extensively by a nurse coordinator, who then helped appointments with specialists and reminded Mr McClaren when to appear.

Mr McClaren also appreciated the fact that his nurse would send an e-mail every few months asking how he felt, and if all health problems have surfaced since their last conversation.

"It helped me incentive to think a little more attention to a nagging problem I put off or that I would not have thought to speak to an annual check-up," he said. "She can go talk to none of my doctors, have an answer or tell me who I should go see. "

Companies such as Pitney Bowes and Quad / Graphics, complete management of chronic diseases is offered at clinics on the site. Both employers say health care costs have significantly decreased accordingly.

At Quad / Graphics, a printing company based in the great Sussex, Wisconsin, all health care expenditures are 30 percent lower than those of similar manufacturers in the region.

Despite the successes, the program management of chronic care is not without challenges. Arranging for the kind of face-to-one care that has proven costly and must be carefully coordinated with the medical staff themselves, who are already overwhelmed by time.

"If the primary care physician are not in the ring, there can be duplication of drugs and other problems," said Dr. Lori J. Heim, president of the American Academy of Family Physicians.

In addition, employees must buy into the programs for them to work. Often, they do. ingrained habits contributing to a chronic disease - lack of exercise, poor diet, lack of sleep - can be difficult to break. Many patients stop taking their prescriptions.

"I would say that less than one third, perhaps even a fifth of people who these programs are targeted to meet effectively," said Dr. Levine.



Barriers can also be psychological. "People with chronic illnesses may suffer from depression. They are busy, they have children and elderly parents to take charge, making it difficult to take care of themselves, "said Dr. Raymond J. Zastrow, president of QuadMed, the subsidiary Health Care Quad / Graphics.

If you suffer from prolonged illness and your company offers one of these programs, please register. You can find the encouragement, support and financial and medical resources you need to better manage your disease and save on your own expenses out of pocket health care.

Here are some tips on how to get the most out of your company's chronic care program.

MAKE THE COMMITMENT Getting Started in one of these programs can be time consuming. Invest the effort it takes to get enrolled. The most comprehensive of the initial visit, the best advice, support and information you receive by road.

This is especially true if you have recently learned of your chronic illness.

"This can be a really scary time," said Brent J. Pawlecki, medical director at Pitney Bowes. "A diabetic, for example, can not read the sugar levels, let alone understand what the numbers mean. Then you can really use the help. " http://jodnet.blogspot.com

Employees PRIVACY QUESTION Many avoid chronic care programs because they fear that their health information will be disclosed to their employers and they suffer unfair consequences as a result. It is an understandable concern, but it is important to remember that companies spend money on these programs are extremely vested in their success.

Most of these companies are careful to hire trusted third-party administrators and to ensure employee health records and other information are never disclosed to officials of the company.

Get what is coming to you for more employees to participate, employers are offering all types of incentives, free gym memberships to reduce health care premiums to reduce copays. Benefits can really add up.

Say you work for Pitney Bowes. If you require regular medication as part of your condition, the company provides an exception to its normal three-tier system - 10 percent of the drug cost for generics, 30 percent for preferred drugs and 50 cent for the least adequate. Those with chronic conditions pay the lowest share, 10 percent, even if the drug is considered less adequate.

With carrots, it can be sticks. Quad / Graphics offers a zero copay on drugs for people with diabetes enrolled in its program of long-term care. (Participants recorded an average of $ 540 last year.) But the employees who cease to participate in the plan to return to regular pay copays.

Tell the doctor Contact YOUR physician employee of a primary care can be one of the biggest challenges in managing a successful program.

In some cases, you may have to nurse Nag employer-based care to call or write to your doctor updates. If you find records of your visits, phone calls or e-mail with your program of chronic care company are not transmitted to your doctor, go ahead and send that information to your own doctor, advised the Dr. Heim.

"Never let a company program to take the place of your visit to the doctor regularly," she added.

Find all the resources sometimes a chronic care program is part of well-being of the employer. In these cases, there should be no problem to find information on job with another company that can help you, such as exercise, nutrition or smoking cessation programs.

But the reality is that because large firms usually contracts with many separate suppliers for these services, their bids are often not well coordinated. Be sure to ask your service benefits of all the resources that may be available for managing your disease, not just those included in the program long-term care.