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An audio newscast from A.M. BestANNOUNCER: Welcome to BestDay Audio.
Today is Wednesday, January 23rd and I am Bryan Cohen.
Stay tuned for an interview with Dr. Paul Handel, Chief Medical Officer for Health Care Service Corporation, regarding the company’s new program to fight obesity – intended to cut members in-patient hospital admissions and emergency costs, slash health care costs and boost members’ workplace productivity.
But first, this word…
You’re listening to BestDay Audio.
FRAN LYSIAK (Senior Associate Editor): I’m Fran Lysiak, Senior Associate Editor with BestWeek, with today’s BestDay Audio Spotlight. Today I’m joined by Dr. Paul Handel who is Chief Medial Officer for Health Care Service Corporation. That is the country’s 4th largest health insurer through its Blue Cross and Blue Shield plans in Illinois, New Mexico, Oklahoma, and Texas. Welcome Dr. Handel.
PAUL HANDEL (Health Care Service Corporation Chief Medical Officer): Fran, thank you very much for asking me to talk with you today.
LYSIAK: I wanted to talk with you today about Health Care Service Corporation’s obesity management program. I’m interested because the company is touting it as being very innovative. Now as we all know, a lot of health insurers and employers in the United States are introducing various wellness programs. What can you tell me about your program—the name—and what is the purpose of it?
HANDEL: That’s a wonderful question. Let me put this into its complete context. I just walked out of a State of Texas hearing on Public Health related to health and wellness. The big topic had to do with the weight issue and the obesity epidemic that this nation is being confronted with at the present time. The importance of this is that in a population of approximately 300 million people, 200 million of us are either overweight or obese. Of that 200 million, 50 million have what is called the metabolic syndrome. The metabolic syndrome, for most people, would be a complex number of findings such as high blood pressure, high blood sugar, high cholesterol and increased waist size. For a woman, it is over 35 inches and for a man it is over 40 inches. The reason we are concerned about that is that we now see that the metabolic syndrome is the most prevalent cause of chronic disease in the United States today. As we get better with our tobacco independence programs there is a real sense that obesity will become the leading cause of cancer in this country. It really behooves us to now take time to look at what we can do to stop this.
LYSIAK: What is Health Care Service Corporation doing?
HANDEL: We rolled out a program that really looks at lifestyle modification and then we took that a step further than anybody else has. We have brought to our organization licensed professional counselors that actually interview people, get them engaged, make sure that they have the willingness to change and then support them throughout the entire process. We’re identifying these people through an extremely robust health risk appraisal. We also are doing this through our predictive modeling tool which enables us to look at claims information and pharmacy information. The health risk appraisal will be able identify people who would be candidates for a lifestyle modification program.
LYSIAK: What would that program comprise? What would they have to do--your members?
HANDEL: There are several components to the program. There are self-help tools that are available on our website that the members can actually go to and get information from dieticians, from trainers and from nurses in secured messaging systems. This allows them to actually, at their convenience, be actively engaged in the program. Additionally, these members are often touched by the licensed professional counselors. These counselors will be with them throughout the duration of the program, talking with them about their willingness to change and the behavior modification things that they need to do. They look for stress points in their lives that the members need to avoid so that they don’t eat. They also talk with them about the critical need for physical activity that is interval to the whole program.
LYSIAK: I have to ask you how many members overall does Health Care Service Corporation have through those four blues plans throughout the United States.
HANDEL: We are caring for about approximately 12 million members.
LYSIAK: Have you identified how many people are obese?
HANDEL: Well that is a beautiful question. I was asked by the chairwoman of the public health committee, “How do you identify these people?” Well, because of HIPPA we really can’t identify them as obese. They need to be self-reported, so I can’t give you an accurate number as to how many of our members are. But if we look at national statistics, 60% of adults and 40% of children are either over weight or obese.
LYSIAK: Your program does sound very interesting. How is it different? Many of your competitors out there have similar obesity management programs. How is it different again?
HANDEL: I think there are several different ways. Number one, I think that the tools that we have – the online tools with the secure messaging – truly represent a state-of-the-art approach to this particular issue. The huge differentiator has to do with the live licensed professional counselors. Those counselors are integral to all of our disease management programs. This ensures members with obesity issues that fall in different places on the continuum of health status truly get the attention they need each step of the way.
LYSIAK: Are the counselors employees of Health Care Service Corporation or are they contracted out?
HANDEL: No ma’am they are employees. These are people that are screened by us, hired by us, and then trained. Most of them have come to us with a significant amount of clinical experience and we use the same mechanism in terms of our screening, hiring, and training that we use for the nurses that do our case and care management.
LYSIAK: I know you definitely want to improve the health of your members at Health Care Service Corporation. My final question is – obviously health insurers also want to help employers cut their health care costs and I’m sure Health Care Service Corporation wants to cut costs as well. Can you give me any sense at all Dr. Handel of the monetary aspect of this—the bottom line?
HANDEL: Sure Fran… Let me give you the hard numbers that we know now. We’ve had a decrease of 4.8% per member per month in terms of health expenses, as compared to a 19% increase in people who are not participating in the program. Those are what I refer to, even in my testimony earlier today, as the hard dollars. What we haven’t measured and what I really want to measure is what we are accomplishing in terms of increased productivity, decreased presenteeism and decreased absenteeism. At the end of the day, I truly believe that’s where we’re going to see the huge difference. Those are the things that are going to make this nation more competitive to global markets.
LYSIAK: I think you share a lot of the views of many of your peers.
HANDEL: It was a thank you very much.
LYSIAK: I’m Fran Lysiak with BestDay Audio Spotlight.