Matthew selwyn bert, mha628, week 3 assignment.
- 1. Disease Management in Johnson & Johnson Selwyn Bert Matthew MHA628: Managed Care & Contractual Services Professor: Dr. Benjamin Newsome June 25, 2012 1
- 2. Introduction The promotion of healthy lifestyle and the prevention of disease through lifestyle changes holds great promise for improving the health of people today and in the future (Bodenheimer, 1999). Johnson & Johnson supports many disease management efforts to promote health and wellness, decrease healthcare costs, and reduce preventable diseases. Their Disease Management (DM) programs are designed to improve the health of people with specific chronic conditions and to reduce healthcare service use and costs associated with avoidable complications. A nutrient-rich diet can help keep your immune system strong, and a strong immune system is your be 2
- 3. The Role of Preventing Disease Johnson & Johnson believes that giving people the tools to stay healthy is as important as helping them when they become sick. Prevention and wellness includes healthy behaviors such as: Eating a well balanced diet, Regular physical activity. Annual doctor visits for physical examination. Following a doctor’s direction, like advice to quit smoking. By encouraging healthy lifestyles Johnson & Johnson believes that they can help reduce preventable d 3
- 4. Preventing Chronic Disease In the US, the Centers for Disease Control & Prevention (CDC), estimates that chronic diseases, most of which are preventable, account for 75 percent of the $2 trillion spent on healthcare. Yet, less than $10 per person per year is spent on preventative health care. Chronic diseases, such as heart disease and diabetes, are more common in the US compared to European countries. 33 percent of Americans are obese, compared to 17 percent in Europe. 53 percent of Americans are smokers, while only 43 percent of Europeans smoke (Thorpe et al. 2007). Many chronic diseases are preventable and can be managed by mitigating risk factors, making lifestyle 4
- 5. Impact of chronic diseases Chronic diseases account for: 81 percent of hospital admissions 76 percent of physician visits 91 percent of all prescriptions filled 75 percent of the $2 trillion spent on healthcare 96 percent of Medicare Spending 83 percent of Medicaid Spending Chronically ill patients use the healthcare system more frequently than any other group. 5
- 6. Johnson & Johnson Actions Johnson & Johnson began promoting healthy lifestyle among their employees many years ago. They established a system of company-wide initiatives established to help their employees live healthier lives. This program includes: Health assessment & counseling to help employees understand and reduce their health risk. Opportunities for employees to be physically active through activities and initiatives offered by the company. Preventative screenings covered at 100 percent under the Healthy People Medical Plan (Ozminkowski et al. 2002). This approach has helped to improve health and reduce costs, both for Johnson & Johnson6companies
- 7. Patient Incentives Johnson & Johnson’s patients’ incentives is grounded in their belief that people will do things for which they are rewarded and avoid those things that can cause harm. Incentives play an important role in their disease management program. Johnson and Johnson also utilizes disincentives, which acts to discourage unhealthy behaviors. Members enrolled in the Healthy People program are eligible for an annual $600 reduction in medical insurance premiums, taken in cash or credited to a Health Savings Account. 30 percent deduction in any gym membership (“Partnership to Fight Chronic Disease,” 2012). The type of incentives, or disincentives, can vary widely, and usually depend on whom they7are targetin
- 8. Physician Incentives Physician incentives programs was designed to facilitate: More rapid and complete member identification and enrollment, and program retention. Improved collaboration between clinicians and plans members, and Higher quality and better chronic care services delivery to plan members. Physicians will receive a payment when they support the program by communicating its value to eligibl 8
- 9. Physician Incentives Incentives are available for: Supporting the program and facilitating the enrollment of more plan members in the disease management program. Locating and furnishing contact information for eligible patients; and Completing a chronic care assessment for each eligible member on the clinician’s patient roster. participating clinicians can also receive incentives for helping to locate and furnish correct contact infor 9
- 10. Physician Incentives Johnson & Johnson provides the following in way of incentives for their physicians: Allows providers to share in the financial savings associated with better care. Provides bonuses to primary care physicians practicing in medical homes (or similar health care delivery models), who exceed benchmarks for consensus-based quality measures Providers that form Regional Accountable Care Networks are eligible for gain sharing bonus payments. The outcomes of the DM incentives program will be used to evaluate future incentives for other program 10
- 11. Case Management Johnson & Johnson offers Complex Case Management programs to improve health care quality and reduce medical expenses for those with complex clinically advanced illnesses. Their Case Management programs helps members get the special attention they need from a variety of resources to help maintain their health and improve quality of life. Specifically trained nurse case managers work closely with members and their doctors to ensure members receive appropriate and timely medical services as cost effective as possible. Providing the right care at the right time in complex health situations leads to financial savings for empl 11
- 12. Case Management Areas Johnson & Johnson focuses on (but are not limited to) for complex case management are: Cardiac care Diabetes High-risk pregnancy Oncology Respiratory Transplant Trauma Johnson & Johnson Case Management provides whole-person care to optimize an individual's health s 12
- 13. Facilities Johnson & Johnson believes that improved outcomes, increases patient satisfaction and lower costs are hallmarks of a well-integrated and well-coordinated delivery system. Their facilities are all conducive to this belief and are designed to enhance healing. Integrated care can improve patient health and safety, particularly for those with chronic conditions. Johnson & Johnson is committed to improving the healthcare system by improving quality 13 patient s and
- 14. Quality of Care Johnson & Johnson’s disease management program that helped guide the care of patients with chronic illnesses appears to improve the quality of care. However, there is little empirical evidence that their disease management efforts actually saved money. People often take for granted that DM prgrams work and save money because the concept seems very 14
- 15. Prescription Benefits J & J disease management in coordination with prescription benefit management is based on establishing protocols for physicians and educating patients not only on proper medication use, but also lifestyle changes to control their disease. J & J continuously monitor prescription use and communicates with providers throughout the delivery process. Reports are generated regularly to provide meaningful interpretation of data regarding analysis of utilization, savings, and the impact of benefit design. DM will greatly benefit members with chronic illnesses and their companies will benefit from control of p 15
- 16. Data use and informatics J & J technology-based disease management applications have been proven to reduce barriers to care, improve quality of care, and cut administrative costs. These applications falls into three broad categories: Data capture and monitoring systems Audiovisual communication systems; and Self-help education and training systems. Deciding which system to use involves considering acceptability, usability, and technical factors. 16
- 17. Conclusion Chronic diseases are ongoing illnesses typically incurable, but can be preventable and managed by mitigating the risk factors associated with these diseases. Chronic diseases are the leading cause of death and disability in the U.S. If unhealthy practices are eliminated these chronic diseases can be controlled or even reversed, saving countless lives and billions of dollars in health care cost annually. 17
- 18. References: Bodenheimer, T. (1999). Disease management Promise and Pitfalls. The New England Journal of Medicine, 240(15): 1202-1205 Ozminkowski, C. et al. (2002). Long-term impact of Johnson & Johnson Health & Wellness Program on healthcare utilization and expenditures. JOEM, 44 (January, 2002) Partnership to Fight Chronic Disease. Retrieved from, http://www.fightchronicdiseases.org/crisis/what/index.cfm Thorpe, K. et al. (2007). Differences in disease prevalence as a source of the US – European healthcare spending gap. Health Affairs (Web exclusive). Retrieved from, http://www.content.healthaffairs.org/cgi/content 18
Editor's Notes
- #3: A nutrient-rich diet can help keep your immune system strong and a strong immune system is your best defense against illnesses.