Health Dialog Connections

Reducing Cardiovascular Risk through Personalized Engagement

Today, more than 84 million people in the United States suffer from cardiovascular disease, accounting for one out of every three deaths in the country. As the leading cause of death for both men and women, it is crucial that people are aware of their risk factors so that they can the necessary steps to take control their health. While not all cases are avoidable, there are core behaviors individuals can adopt to drastically improve overall cardiovascular health.

Since 2012, The Centers for Medicare and Medicaid Services (CMS) has mandated that each Medicare Advantage (MA) plan conduct a chronic care improvement program (CCIP) over a five-year period that focuses on reducing the incidence and severity of cardiovascular disease. To effectively lower the chances of members developing heart disease and to subsequently reduce overall healthcare costs, early action is key.

Health plans have a unique opportunity to educate their members who are at risk as well as to help members with the disease manage their condition.

Key Risk Factors

While uncontrollable factors, such as age and genetic predispositions, can increase risk of heart disease, there are several specific conditions and personal habits that are more likely to contribute to the risk. Some of the most common include: hypertension, high cholesterol, smoking, diabetes, obesity, physically inactivity, and an unhealthy diet.

According to the American Heart Association (AHA), approximately 86 million Americans currently have high blood pressure, 23 million adults have diabetes and 87 million have pre-diabetes. Additionally, the AHA reports that 20 percent of American adults are routine smokers, while an estimated 68 percent are overweight or obese. As an increasing number of individuals find themselves in greater risk, they must understand and implement the necessary lifestyle changes to successfully prevent and manage these conditions.

Inspire Behavior Change

To effectively minimize risk factors and improve heart health, members can change unhealthy lifestyle behaviors by taking action early on. In doing so, they can start to alleviate certain symptoms, slow disease progression and improve overall quality of life.

Inspiring a lifestyle change is no easy feat, however. People are often challenged by staying motivated, physical limitations, time management issues, lack of confidence, limited knowledge, fear, financial limitations, language barriers, stress, and more. To effectively reduce further progression, health plans should provide access to member outreach programs, opening up the lines of communication to collaborate with medical professionals. This not only enables members to overcome potential hurdles, but it also helps them determine the best strategies for long-term results.                                      

Necessary Lifestyle Changes

Members should focus on three core areas when reassessing their lifestyles and determining the proper modifications: nutrition, physical activity and medication management.

A heart-healthy diet is the centerpiece of reducing the likelihood of cardiovascular disease. When an individual has been following the same diet for years, however, this transition can be complex. Through effective programs, plans can help by educating members about nutrition basics, developing a tailored meal plan, providing access to recipes and health meal tips, and encouraging the use of nutrition trackers to monitor progress toward overall nutrition goals.

Additionally, at-risk members should also increase their levels of physical activity to maintain a healthy weight. Plans can play a role by offering programs that educate members about effective exercises, creating physical activity plans customized for each individual, and encouraging the use of physical activity trackers to monitor progress.

Medication management is also critical to improving cardiovascular health. With access to healthcare professionals through dedicated outreach programs, members can improve overall medication adherence. Industry experts can not only provide medication reviews and support for polypharmacy, but they can also encourage the use of medication reminders and trackers, and support the development of a symptom response plan for at-risk members.

Finally, by offering programs that are easily accessible which both engage members and assist them to start with small achievable steps are the best solution. With access to continuous health coaching support, digital tools and community resources, members can effectively monitor their blood pressure, stop smoking, better manage their stress, get adequate rest, and reduce alcohol intake – all factors that can improve heart health.

It Really Works!

Health Dialog collaborated with a regional health plan to develop an outreach program focused on cardiovascular risk reduction for the five-year CCIP requirements for MA plans. The targeted population, 49 percent of which was 75 years or older, included members both at risk for coronary heart disease, diabetes, and hypertension and those who were managing their condition (identified as low- to medium-risk).

The intervention program produced considerable results, including:

  • 54% increased likelihood of LDL screenings
  • 6% reduction in members non-adherent to blood pressure medications
  • 17% reduction in all-cause inpatient admissions
  • $1,100 PMPY average medical cost savings

As the healthcare industry continues its transition to value-based care, now is the time for health plans to implement cost-saving solutions designed to improve the health of their members. If you’re interested in innovative solutions that can drive meaningful and lasting behavior change for your population, check out our recent webinar on reducing cardiovascular risk with personalized engagement.

About Peter Goldbach, MD:

Dr. Goldbach brings more than 30 years of medical experience to Health Dialog’s management team, including 15 years in medical administration and 17 years maintaining a primary care and pulmonary disease practice. Prior to joining Health Dialog, Dr. Goldbach served as President and Chief Executive Officer of Med-Vantage Inc., a healthcare informatics and engagement company. Earlier in his career, he served as Medical Director for Blue Cross Blue Shield of Massachusetts, where he provided medical direction for the company's "Pay for Performance" and eHealth programs, and held CEO, trustee, and medical staff president positions with two Boston-area community hospitals. Dr. Goldbach received undergraduate and master's degrees from UCLA before earning his medical degree from SUNY Downstate Medical Center College of Medicine. He completed his Internal Medicine internship and residency at George Washington University Hospital, and his Pulmonary Disease fellowship at Cedars-Sinai Medical Center / UCLA School of Medicine.

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