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State of Florida and LifeMasters Extend Medicaid Disease-Management Program that Improves Health, Lowers Costs

$12.6 Million in Health Care Cost Reductions for Medicaid Through Preventive Care - a 16.3% Cost Reduction

Thousands of Floridians Healthier, Spending 38% Fewer Days in the Hospital

TALLAHASSEE, Fla. and IRVINE, Calif. (November 12, 2003) - Following three years of significant improvements in beneficiary health and net reductions in health care expenditures, the State of Florida and LifeMasters Supported SelfCare, Inc. have agreed to extend by three years the disease management program LifeMasters has been providing to thousands of Florida Medicaid beneficiaries with congestive heart failure (CHF). In partnership with Florida's Agency for Health Care Administration (AHCA), LifeMasters reduced health care costs for Florida's Medicaid program by $12.6 million dollars in the first two years of the program, representing a 16.3 percent decline in health care costs for the covered population. After program costs are taken into account, total costs for the population went down by almost 6%.

Under the program, which began in September 2000 and will now continue through 2006, Medicaid beneficiaries receive disease management services for their congestive heart failure and all related conditions and co-morbidities including diabetes, COPD, hypertension, and depression. The program also includes beneficiary-specific health education, lifestyle-modification support, regular telephonic interaction with a clinical nurse consultant and regular monitoring of the beneficiary's vital signs and symptoms for early identification of changes in health status. In addition, LifeMasters communicates with the beneficiary's physician whenever a clinical problem arises. LifeMasters provides beneficiaries with equipment such as digital scales, electronic blood pressure cuffs and even telephones, should they be needed. This customized program created for AHCA includes the use of local personnel to help locate and train new program participants and coordinate with local hospitals, physician offices, community support services, and AHCA area offices to support the special needs of Medicaid populations.

Studies have shown that medical expenses incurred by individuals with chronic illness account for a disproportionate share of health care expenditures in this country. By keeping individuals healthy and following the best standards of care, preventable hospital admissions, hospital lengths of stay, and emergency department visits are reduced. In its first two years, Florida Medicaid beneficiaries in the LifeMasters program spent 38 percent fewer days in the hospital than before the program began.

"Under Gov. Bush's leadership, Florida has become a model for other states in providing disease management care to Medicaid beneficiaries that results in substantial cost savings and improvements in health outcomes, proving that improved quality and access to care can co-exist with lower costs " said Christobel Selecky, LifeMasters' CEO. We are proud of our partnership with Florida and look forward to another three years of improved health and lowered costs."

"It is widely known in the medical community that those with CHF need to keep a close eye on their blood pressure, medications, diet and lifestyle - and yet so few actually do," said Rhonda M. Meadows, MD, FAAFP, Secretary of AHCA. "Our partner, LifeMasters, helps people stay on track with these standards of care by proactively engaging and supporting our beneficiaries and their providers, resulting in healthier people that spend less time in the hospital. We are pleased to be working with LifeMasters for another three years."

Earl Ammon, 59, of Newberry, is just one remarkable example of the impact that LifeMasters' program has had in Florida. Mr. Ammon entered the LifeMasters program with CHF. He also struggled with secondary conditions that included hypertension, diabetes and obesity. Mr. Ammon's personalized intervention program included weekly calls with his LifeMasters clinical nurse consultant as well as modifications to his diet. Mr. Ammon received exercise materials and his vital signs were closely monitored with equipment supplied by LifeMasters. As a result of his participation in the program, Mr. Ammon lost 100 pounds and was taken off his diabetes medication and several heart medications by his physician. "Now I know a lot more about how things affect my diabetes and my heart," said Mr. Ammon. "I call in my blood pressure, glucose and weight to LifeMasters, and if one of my numbers is off, they call every time. Now my heart is getting better."

More than 8,000 Medicaid beneficiaries in Florida with CHF have received LifeMasters' services over the past three years, with 3,700 currently enrolled. In its first two years, the LifeMasters disease management program has generated the following improvements in quality and cost metrics across the entire population (all risk levels) involved in the program:

• 38% reduction of days in the hospital


• Percent of beneficiaries on ACE inhibitor/angiotensin receptor blocker therapy rose from 58.1% to 76.5%


• Percent of beneficiaries on beta blockers increased from 30.2% to 44.1%


• Percent of beneficiaries receiving an annual cholesterol screening increased from 30.3% to 53.8%


• 25% of participants reported stopping smoking; 40% reported reducing the number of cigarettes


• An average of five pounds per participant was lost across the population with many participants losing significantly more - over 200 pounds in one notable case

These outcomes were calculated using an approach developed for AHCA by a third-party consultant who is an independent expert in predictive modeling and health care cost evaluation.

About The Agency for Health Care Administration (AHCA)
Working to improve access to affordable, quality health care to all Floridians, the state Agency for Health Care Administration administers Florida's $12 billion Medicaid program; licenses and regulates more than 22,000 health care facilities and 25 health maintenance organizations; and publishes health care data and statistics.

For More Information Contact:

Connie Barnes Agency for Health Care Administration (850) 922-3809 barnescw@fdhc.state.fl.us