HEART FAILURE DISEASE MANAGEMENT

OptumHealth’s Heart Failure Disease Management program is designed to reduce unnecessary hospitalizations and health care costs and improve health for people with heart failure.

The program is based on American Heart Association and American College of Cardiology clinical guidelines for heart failure and includes:

• Comprehensive assessments by specialty-trained registered nurses to determine the appropriate level of intervention
• Proactive outbound and responsive inbound nurse calls
• At-home monitoring of weight and related symptoms
• Immediate nurse interventions if the member’s weight or other symptoms change
• Alert reports — sent to physicians if significant issues are detected. If no alerts are triggered, a monthly summary report is sent to facilitate data sharing on critical findings
• Medication therapy monitoring and adherence management for beta blockers, angiotensin converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARB)
• Educational materials and behavior change programs
• Education on complying with physician treatment plans and drug therapies
• Management of risk factors and co-morbidities including hypertension, asthma, diabetes, coronary artery disease (CAD), chronic obstructive pulmonary disease (COPD), and depression
• Satisfaction and quality-of-life surveys

About Biometric Monitoring
Real-time tracking of weight and related symptoms improves the effectiveness of interventions and helps support adherence to physician treatment plans for improved outcomes. To support this aspect of the program, a scale and biometric monitoring system are shipped directly to each heart failure program participant. The system is simple to set up and use. The participant is asked to step on the scale and answer questions twice a day, and the monitor then transmits the results over their phone line (toll free) to an OptumHealth disease management nurse. Nurses review the data reported daily. If there is a significant weight or symptom change, a nurse calls the member to verify the information and then notifies the designated physician by fax. The nurse then contacts both the individual and the physician to help ensure that follow-up occurs in a timely manner.

The Heart Failure Program has delivered the following results:

• 8.1% reduction in emergency room visits
• 6.1% reduction in admissions
• 11% reduction in days
• 97% satisfaction rate