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NEW STUDY SHOWS COACHING TO PATIENT ACTIVATION LEVELS IMPROVES DISEASE MANAGEMENT OUTCOMES Reduced Hospital and Emergency Room Utilization Leads to Cost Savings IRVINE, Calif., June 10, 2009 – People with chronic health conditions who receive coaching tailored to their level of health activation showed significant improvements in clinical outcomes, and experienced fewer hospitalizations and visits to the emergency room than those coached using traditional methods, according to a study published in the June issue of The American Journal of Managed Care. The study, led by Judith Hibbard, Ph.D. and colleagues at the University of Oregon, compared the behaviors of patients receiving standard telephone disease management (DM) coaching with those who received more tailored coaching based on their “activation level” as part of a DM program offered by the health improvement company LifeMasters Supported SelfCare, Inc. Activation levels are determined by the Patient Activation MeasureTM (PAMTM), a survey tool developed by Hibbard and colleagues to assess an individual’s knowledge, skills and confidence in playing a role in one’s own health and healthcare. “LifeMasters is continually implementing new methodologies and tools to improve outcomes,” said Mary Jane Osmick, M.D., Vice President and Medical Director. “We have learned that deploying targeted interventions rather than using a ‘one size fits all’ approach is a critical success factor. Our nurses and coaches are the first in the DM industry to provide individual patient support by applying a fully integrated coaching model that includes the PAM. The findings reinforce our understanding that improved activation is an overarching measure of success that leads to significant clinical improvement and financial savings. ” The quasi-experimental research, which was conducted in a real-life DM setting, included an intervention group and a control group of nurse coaches and their patients in geographically separate call centers, which were selected based on the similarity of their nurse coaches’ tenure and years of experience. The findings show those who received coaching with the PAM experienced a 33% decline in hospital admissions compared to the control group, which remained flat, and a 22% decline in emergency room visits compared with an increase of 20% in the control group. The PAM group also experienced statistically significant improvements in diastolic blood pressure and in LDL cholesterol levels relative to the control group, and increased their adherence to recommended immunization and drug regimens, including the influenza vaccine. The PAM score intervention group showed fewer hospital stays, which translated into a savings of $145 per person per month for the intervention population. A similar decline was seen in visits to the emergency room among this group, which equates to an $11 per person per month savings. “The PAM is unique among social science-based assessments in that it measures an individual’s underlying health belief structure. This structure reflects the degree to which the person feels in charge of his or her own health and healthcare, and is the basis for a whole spectrum of health behaviors. This creates a more holistic view of the individual, one which is essential to providing effective support,” said Dr. Hibbard. The Patient Activation Measure, which is licensed and marketed by Insignia Health, consists of a 10 or 13-question survey that asks people about their beliefs, knowledge, skills and confidence for engaging in a wide range of health behaviors. Based on responses to the survey, each person is assigned an activation score and level. The PAM segments participants into one of four progressively higher activation levels. At the low end of the spectrum, individuals tend to be passive in managing their health, and may fail to see the connection between their own behaviors and health outcomes. At the high end, individuals understand that relationship and have become good self-managers across a constellation of behaviors. However, even high activation level individuals show opportunities to improve and can benefit from coaching to help them stay on course in times of stress or change to their routine. More than 85 studies have documented the PAM’s ability to effectively measure patient activation and to predict a range of behaviors in wide demographic and socioeconomic variability. Research has shown that higher levels of activation rates correlate with improved self-care behaviors. In fact, the Hibbard study demonstrated that PAM scores increased 4.6 pts for the intervention group compared to just 1.4 points for the control group, demonstrating that the tool improved the patients’ ability to manage their conditions. “Tailoring support to an individual’s level of activation and self-management ability allows coaches to address the competencies that drive the behaviors critical to better health and the more efficient use of healthcare resources,” said Chris Delaney, Insignia’s Chief Executive Officer. “This study clearly demonstrates the benefits of this patient-centric model.” Funded by the Health Industry Forum at Brandeis University, the study and its practical applications will be discussed on September 21-22 at DMAA: The Care Continuum Alliance’s Forum 09 conference in San Diego. The American Journal of Managed Care is an independent, peer-reviewed publication dedicated to disseminating clinical information to managed care physicians, clinical decision makers and other healthcare professionals. For a copy of the study, go to www.ajmc.com. About Insignia Health |
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