Managed Care - March 2008 - (Page M7) Integrative Approaches to Health Care JUAN C. PRIETO, LCSW, CEAP Health Benefits Manager, IBM I BM’s corporate vision is that positive effects on emif the HRA indicates that the member is at risk, the memployees’ health and productivity can be achieved ber is so notified. The HRA is separate from the health through a concerted effort involving not just the pascreenings that vendors conduct when members enter tient but also the patient’s family, physicians, and health their system. care vendors. As a very large employer, IBM has the leverOnce the personal care consultant has become involved age to work with vendors to integrate behavioral health with a member, the next step is to refer that member to care with other aspects of health care. the appropriate service. Some members Within IBM’s covered population of may be referred to the Life Balance pro550,000 employees, retirees and dependgram, which connects them with coments is a subpopulation of 70,000 patients munity resources for child and elder care, with chronic conditions, many of whom for example, but a coach is available online have behavioral health comorbidity. IBM or via telephone to make sure the member has instituted a program to identify as receives all the needed support. Others many of these patients as possible to help may be referred to mental health or subthem with their behavioral health needs stance abuse programs. If the issue to be and, in turn, address their medical needs. resolved is not too complex, the member This article describes only IBM’s promight participate in an employee assisgram, which may or may not be applicatance program (EAP). Otherwise, the ble to other workplace programs. member is referred to the managed behavThe program has a single point of entry ioral health program, which is carved out JUAN C. PRIETO, — the personal care consultant. A patient from IBM’s five self-insured medical proLCSW, CEAP can reach the consultant in various ways, grams. Our Life Solutions member supwhich include nonclinical resources within the company port program covers comorbid behavioral conditions, that identify employees who may benefit from the prosuch as depression, anxiety, stress, and substance abuse. gram and numerous referral tools (Table 1). Completing a health risk assessment (HRA) entitles an Activity, nutrition, and weight management IBM offers a $150 cash payment to employees who IBM employee to a $150 rebate. Results are sent to venparticipate in a physical activity and nutrition/weight dors so that they can provide support as necessary, and TABLE 1 Pathways for reaching the personal care consultant IBM IDENTIFICATION SOURCES Health risk assessment Changes in life status (e.g., marriage, death in family, new child, retirement) Promotional campaigns Seminars and health fairs IBM intranet Child care, elder care Critical incidents (e.g., accidents in the workplace, job restructuring, deaths) Acquisition of new companies Vendor’s web site IBM REFERRAL SOURCES Disease management Disability Self-referral SCCAP (community action programs) Medical/primary care physician Pharmacy data Global Well Being Services Nurse referrals Health screening SUPPLEMENT / 2007 MEDICAL DIRECTOR COLLOQUY 7
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