Managed Care - March 2009 - (Page 28) Modern Cardiovascular Programs Cut Costs, Inpatient Days, and Deaths Harvard Pilgrim Health Care has striven methodically to become superior in cardiac care. Its numbers tell the story. By Lola Butcher Contributing Editor he statistics for cardiovascular disease and stroke can seem overwhelming: 1 in 3 American adults has at least one type of cardiovascular disease; more than 1.2 million will have a heart attack this year; and 795,000 will experience a stroke. Cardiovascular disease, which accounts for more than 30 percent of U.S. deaths, is expected to ring up direct and indirect costs of $475 billion in 2009, far more than any other disease category. But another statistic — the death rate from cardiovascular disease declined by more than 26 percent from 1995 to 2005 — gives health plans something positive to focus on. The grim reaper that is cardiovascular disease can be fought successfully. That’s what Harvard Pilgrim Health Care (HPHC), a not-for-profit plan covering more than 1 million members in Massachusetts, New Hampshire, and Maine, has focused on for most of this decade — and with good effect. The rate of emergency room visits and inpatient stays for cardiac events for Harvard Pilgrim members fell from 3.31 per 1,000 members in 2000 to 2.29 in 2007; the national average was 3.5 cardiac events per thousand or greater for each of those years. HPHC has been named the No. 1 health plan in the country by the National Committee for Quality Assurance for the past four years. Lydia Bernstein, the plan’s director of clinical programs, discussed the programs that are helping Harvard Pilgrim brandish a sword against heart disease and stroke. T CHRIS FITZGERALD Prevention and DM Through its Healthy Returns worksite program, Harvard Pilgrim sends nurses and health educators to offices and factories to help plan members lose weight, stop smoking, and lower their blood pressure. The pro- Harvard Pilgrim not only awards bonuses to effective doctors based on HEDIS scores, but gives them public recognition as well, notes Lydia Bernstein, the plan’s director of clinical programs. 28 MANAGED CARE / MARCH 2009
For optimal viewing of this digital publication, please enable JavaScript and then refresh the page. If you would like to try to load the digital publication without using Flash Player detection, please click here.