Engaging Physicians in Risk Factor Reduction
- 1 October 2010
- journal article
- research article
- Published by Mary Ann Liebert Inc in Population Health Management
- Vol. 13 (5), 255-261
- https://doi.org/10.1089/pop.2009.0072
Abstract
OptumHealth tested the feasibility of physician-directed population management in 3 primary care practices and with 546 continuously insured patients who exhibited claims markers for coronary artery disease, diabetes, and/or hypertension. During the intervention portion of the study, we asked physicians to improve the following health measurements: blood pressure, body mass index, cholesterol, hemoglobin A1c, and smoking status. We offered a modest pay-for-outcomes incentive for each risk factor improvement achieved. Additionally, on an eligible subset of these patients, we asked physicians to actively refer to population management programs those patients they determined could benefit from nurse or health coach interventions, advising us as to which components of their treatment plan they wished us to address. The 6-month intervention period exhibited a 10-fold improvement in the trend rate of risk factor management success when compared to the prior 6-month period for the same patients. A net of 96 distinct risk factor improvements were achieved by the 546 patients during the intervention period, whereas 9 net risk factor improvements occurred in the comparison period. This difference in improvement trends was statistically significant at P < 0.01. Of the 546 study participants, a subset of 187 members was eligible for participation in OptumHealth care management programs. Physicians identified 80 of these 187 eligible members as appropriate targets for program intervention. Representing ourselves as “calling on behalf” of the physician practices, we established contact with 50 referred members; 43 members (86%) actively enrolled in our programs. This enrollment rate is 2 to 3 times the rate of enrollment through our standard program outreach methods. We conclude that physician-directed population management with aligned incentives offers promise as a method of achieving important health and wellness goals. (Population Health Management 2010;13:255–261)Keywords
This publication has 10 references indexed in Scilit:
- The Preventable Causes of Death in the United States: Comparative Risk Assessment of Dietary, Lifestyle, and Metabolic Risk FactorsPLoS Medicine, 2009
- Leveraging the Trusted Clinician: Increasing Retention in Disease Management through Integrated Program DeliveryPopulation Health Management, 2008
- The value of ambulatory care measures: a review of clinical and financial impact from an employer/payer perspective.2008
- The "trusted clinician": an alternative approach to worksite health promotion?American Journal of Health Promotion, 2008
- Can Disease Management Transform Health Care?Disease Management, 2007
- Leveraging the Trusted Clinician: Documenting Disease Management Program EnrollmentDisease Management, 2007
- Pay-for-Performance and Accountability: Related Themes in Improving Health CareAnnals of Internal Medicine, 2006
- Physician Use of Disease Management ProgramsDisease Management, 2005
- Predictors of Health Care Costs in Adults With DiabetesDiabetes Care, 2005
- Effect of Improved Glycemic Control on Health Care Costs and UtilizationJAMA, 2001