NC HealthSmart: Promoting Optimal Health and Wellness for SHP Members

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NC HealthSmartPromoting Optimal Health and
Wellness for SHP Members

• NC Medical Society Quality Subcommittee
• August 2009
• Derek Prentice, MD, Consulting Medical Director
• Anne B. Rogers, RN, BSN, MPH, Director of IHM

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What is NC HealthSmart?

• North Carolina HealthSmart is a population health
  initiative that aims to
• Empower healthy members to stay healthy
• Help those with chronic disease or disease risk
  factors to better manage their health
• Offer integrated, cutting-edge resources and
  programs to members at work, at home, and through
  their health care provider

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Guiding Principles of NC HealthSmart

• Reinforce and strengthen the patient-provider
  relationship
• Empower individuals to play active role in
  management of their health and health care
• Improve health of members and their families
• Improve quality of care
• Engage employers in health care issues
• Increase member satisfaction
• Stabilize Plan and member health care costs

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NC HealthSmart Eligible Members
Members eligible for NC HealthSmart services are
members whose primary health insurance is through
the NC State Health Plan (all except Medicare
Primary).
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HealthSmart Components

• 24/7 Health Coaching Health Dialog
• Disease Management Health Dialog
• Personal Health Assessment/Web Tools Health
  Dialog
• Physician Support/Clinical Gap Identification
  Health Dialog

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HealthSmart Components

• Intensive Case Management/High Risk
  Maternity/NICU SHPS
• ESKD/CKD Care Management KidneyTel (formerly
  Renaissance HC)
• Health Promotion and Education
• SHP Staff/All Vendors/DHHS
• Worksite Wellness
• SHP/DHHS/Division of Public Health

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NC HealthSmart Results

• Program Participation
• Clinical Impacts
• Member Satisfaction
• Provider Satisfaction

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Participation

• Over 45,000 members ( 9) currently served by
  Disease and Case Management programs
• Representing 25 of SHP expenditures
• Focusing on members with coachable conditions
  and members with the most need
• 21 ROI Chronic Disease Trends report

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Clinical Impacts

• Member adherence to clinical guidelines (meds,
  tests, exams)
• 92.4 asthma controller meds
• 82.1 CAD - lipid meds
• 77.0 diabetes - microalbuminuria tests
• 47.4 diabetes - eye exam
• Smart Registry and Provider Support Services

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Member Satisfaction

• 85 Satisfied with Health Coach
• 93 Likely to Recommend Program

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Provider SatisfactionN 234 3,000 surveys
mailed

• 77 are aware of NC HealthSmart
• 88 found the Provider Services Specialists
  helpful
• 79 found the SmartRegistry helpful
• 74 have a positive opinion of NC SHP as a result
  of NC HealthSmart

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Worksite Wellness/Health Promotion

• Preventive Services
• Worksite Wellness Infrastructure
• STAR and Highway to Health
• Comprehensive Wellness Initiative
• (SL 2009-16)
• Tobacco Cessation Supports
• Weigh Less program expansion
• Benefit changes

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Opportunities

• Disease and Case Management RFP
• Discussions with various stakeholders
• NCMS
• CCNC/DMA
• NCAFP
• BCBSNC

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• Questions or Comments??