Cardiovascular Disease Management and Risk Reduction

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Cardiovascular Disease Management and Risk
Reduction The Business of Good Health
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TI Automotive a global Tier 1 automotive
industry supplier employing 23,000 in 28
countries 4,200 employees in 29 US facilities
Health Navigators 10.10.06
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GLOBAL FACTS

• U.S.A 6,500/worker/year
• GM 5.2 billion 2,223/car
• Canada 800/worker/year
• Toyota 186/worker/year
• China/India

Source Newsweek, April 18, 2005
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Claims Analysis
Health Navigators 10.10.06
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COST of MANAGING CHRONIC DISEASE
References 1 The benefit and cost of prostate
cancer early detection. The Investigators of the
American Cancer Society-National Prostate Cancer
Detection Project (http//caonline.amcancers
oc.org/cgi/content/abstract/43/3/134) 2 Open
heart surgery vs. angioplasty long-term benefits
weighted (http//mednews.stanford.edu/releases/19
97/janreleases/hlatky.html) 3 Lifetime cost of
stroke in the United States (http//www.ncbi.nlm.
nih.gov/entrez/query.fcgi?cmdRetrievedbPubMedl
ist_uids8784113doptAbstract) 4 Cost
effective drug choices (http//www.consumerreport
s.org/mg/cost-effective-drug-choices/cedc_statins.
htm) 5 Cost Effectiveness of Statin Therapy for
the Primary Prevention of Major Coronary Events
in Individuals With Type 2 Diabetes
(http//care.diabetesjournals.org/cgi/content/abst
ract/26/6/1796) 6 Cost Of Treating Diabetes
Surges, US http//www.medicalnewstoday.com/medica
lnews.php?newsid56840
Health Navigators - 2006
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Shock Claims

• Diagnosis YTD Cost
• Leukemia 383,082
• Heart Transplant 279,863
• Malignant Breast Cancer
  261,262
• Fractured Neck 255,002
• Renal Failure 222,482
• Malignant Bladder Cancer
  214,443
• Burns/Fractures 192,209
• Intracranial Hemorrhage
  167,610
• Cervical Spinal Stenosis
  162,615
• Aortic Valve Disorder 160,632
• Colon Cancer 151,520
• Cranial Cancer 146,062
• Rheumatoid Arthritis
  145,483
• Uncontrolled Diabetes
  127,689
• Lung Cancer 127,233
• Lung Cancer 126,085
• Lumbar Disc Displacement 124,702
• Intestinal Obstruction 123,686

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CVD R COSTS
x
1 LIPITOR 2 ZOCOR 3 PLAVIX

• Averaged 417 CVD Prescriptions Per Month
• 47,250 Per Month Cost to TI

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FOCUS ON ROOT CAUSES
GOAL Reduce the At Risk Population
Heart Disease
High Risk
Elevated Lipids Abnormal Glucose High Blood
Pressure Overweight
Indicator
Shared Risk Factors
RISK REDUCTION
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FOCUS ON ROOT CAUSES
The Logic of Targeting Heart Disease and Stroke

• CVD is the number one killer in every city and
  county in the country.
• CVD shares risk factors with certain cancers,
  diabetes digestive
• disorders and other chronic diseases.
• CVD is the 1 cause of death for people with
  diabetes

To reap the greatest benefits from wellness and
disease management programs, the employer must
target the most prevalent diseases within its
population. - Health Care at the Crossroads,
Page 34
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ESSENTIAL ELEMENTS

• Focuses on Cardiovascular Disease

• Formally define provider/partner roles as part
  of the health plan

• Includes health screening in benefits design

• Follows evidence based medical standards

• Stratifies risk based upon clinical findings

• Directs high-risk to interventions that
  lower risk normalize lab values

• Distributes non-compliant/un-successful into
  appropriate management

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CREATIVE PLAN DESIGN
80/20
Base Plan
80/20
Participation In Screening Interventions
1000 Deductible
Premium Plan
250 Deductible
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IDENTIFY ROOT CAUSES
Identify Associates at High Risk
HRA - BMI - Blood Pressure
- Glucose - Lipid Profile
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ESSENTIAL ELEMENTS

• Focuses on Cardiovascular Disease

• Formally define provider/partner roles as part
  of the health plan

• Includes health screening in benefits design

• Follows evidence based medical standards

• Stratifies risk based upon clinical findings

• Directs high-risk to interventions that
  lower risk normalize lab values

• Distributes non-compliant/un-successful into
  appropriate management

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Cartersville Screenings

• 98 Participation
• 280 Screenings Conducted
• 60 spouses
• 32 Identified at High Risk
• Cholesterol levels of 240 or higher
• 29 Enrolled in Risk Reduction Program

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ELIMINATE ROOT CAUSES
8 WEEK Risk Reduction
Tell me and I forget, Teach me and I remember,
Involve me and I learn. - Benjamin Franklin
Risk Reduction Dietitian
Aggressive Direction
Can Do Philosophy
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PREVENTION
Why is By-Pass Surgery conservative And a Plant
Based Diet radical? -Dean Ornish
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HEART DISEASE RISK
Number of Individuals At Risk Before and After
Risk Reduction Program
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5
Start
Finish
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WEIGHT Before and after program
BLOOD PRESSURE High readings - before and after
program
This was not a weight-loss program
203
190
7
2
Start
Finish
Test 1
Test 2
Average Weight Loss 13 lbs
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Fall 2005 Screenings

• 96 Participation
• 2396 Participants Screened
• 330 Identified at High Risk
• Cholesterol levels of 240 or higher
• 41 Newly Diagnosed Diabetics

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HEART DISEASE RISK - Cholesterol
Number of Individuals at risk Pre and Post
Programs
330
Participants at risk
56
Participants at risk
?76
Start
Finish
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BLOOD PRESSURE RISK
Number of Individuals at risk Pre and Post
Program
55
at risk
30
at risk
?45
Start
Finish
This was not a Blood Pressure Control Program
Blood Pressures are highly variable from day to
day Diastolic Blood Pressure only
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WEIGHT CHANGE
Average Weight Pre and Post Programs
198.3
Average
193.5
Average
?4.8lbs
Start
Finish
This was not a Weight Loss Program 64 of
participants lost weight
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TI Automotive Locations CVD Risk Reduction
Program Highlights
2005-2007
Data reported is through 04.02.07 - Health
Navigators
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ATTITUDE
Whether you think you can or think you cant.
Youre Right -Henry Ford