Patient Advantage will impact the health care needs of your employees and their families, no matter how large your organization.
Health cost containment, risk management, reduction of lost work time, and cross-over savings with your Worker’s Compensation experience are our focus. Services can be customized to fit your organization’s scheduling requirements and budget. The program can assist your member employees with:
We use a Health Attitude Screen to predict who is likely to become ill in the next year. We focus our efforts on your high dollar claim areas.
Proactive Nurse Reach Out and Patient Advocacy
We find those who need help in real time and effectively help them get their needs met. We help your members navigate the health care system for their complex illness or crisis.
Personal Health Information Search
We find health information answers to the questions your members have when they are faced with a serious diagnosis or complex illness.
The Patient Advantage Challenge is a robust cardiac/fitness/weight loss/nutrition program. The Back, Neck, and Joint Program is an injury prevention program that is an effective way to reduce the injuries to the back, neck, shoulders, and wrists.
Patient Advantage Nurse Advocates meet with employees face to face to health issues.
Health Savings Account Counseling
Patient Advantage Nurse Advocates will meet with employees who have High Deductible Health Plan/Health Savings Account plans to help them:
- Understand their benefits
- Budget their money more effectively
- Negotiate with providers for the best fee
Health Attitude Screen
Using a Health Attitude Screen to understand how a person interacts with the healthcare system helps the Nurse Advocate to understand if a person is able to get his or her health needs met. This gives a predictive value to the survey that helps in identifying who is likely to face a preventable catastrophe and to be able to initiate an intervention before the catastrophe occurs. It is also a minimally invasive questionnaire and is more likely to obtain information that is true and complete.
Red Flag Questions
The Health Attitude Screen is designed to identify gaps where health care needs are not adequately met. An example would be to ask if a member has a doctor, and follow up with a question that identifies if they trust their doctor, if they communicate with their doctor, and if the doctor hears them concerning their secondary or tertiary complaint. All of these questions go to the effectiveness of their primary care. Other questions go to identifying if the member has the resources to deal with the health challenges they may be facing at that time or other health issues. Medication errors, hospital readmissions, lack of accessing preventative services, and other key preventable catastrophes can be prevented by knowing this information.
Patient Advantage only hires nurses who are RNs and have at least ten years experience in multiple settings in the field. These professionals are skilled at assessing the needs of the situation and, with the supervision and guidance of the Medical Director, create a care plan that will help the member get their needs met.
Finding the 20% who cost 80% of the dollars
It is a well documented fact that most of the time, 80% of the health care dollars will be consumed by only 20% of the members. The Health Attitude Screen is a tool used to quickly identify which members are more likely to be part of the 20%. The analysis of the Health Attitude Screen is a segway to meet with and engage the member and have an opportunity to discuss the health issue at the worksite or in the privacy of their home.
Proactive Nurse Service
The pre-emptive identification of members who are at risk to develop chronic diseases and effectively apply all of the known techniques to delay or avoid the onset of these diseases is the most effective way to reduce health care expenditures and hospitalizations. For members who have already been diagnosed with a chronic disease, guidelines for managing that illness can be taught to members to minimize the impact of the disease on their life as well as minimize the health care resources consumed by that member.
Patient Advocacy Service
Patient Advantage, LLC has a team of registered nurses who have at least ten years of experience in the field in multiple settings who will act as an advocate for a member or the member’s loved ones. Members who are identified as being at risk for a chronic disease or a preventable medical catastrophe will meet one on one in their workplace or home to learn what changes they can make to help delay or avoid the onset of these illnesses. If there is an illness that has progressed to the point where they are already manifesting symptoms, then the current guidelines for managing that illness will be discussed with the member. An action plan for optimizing their health will be developed in conjunction with that individual’s unique needs. The Nurse Advocate will also communicate with the member’s physicians if there are questions or issues that the member or the member’s family have regarding treatment recommendations, prognosis, or the physician’s expectations. They will also co-ordinate care and facilitate referrals when necessary.
Health Information Search Service
Patient Advantage has a team of professional medical information searchers who have at least ten years of medical research or medical information internet experience. When a member has a need for information regarding a specific diagnosis, a searcher is assigned to that case to thoroughly research the diagnosis and associated questions. The information is compiled into a report that is usually between fifty to one hundred pages long and is then edited to a simple reading level. This report is then bound and hand delivered to the member’s home or work site by a Nurse Advocate who will stay until the member is satisfied that they understand the illness and the associated questions.
Patient Advantage Challenge
The Patient Advantage Challenge is a Program the uses both nutrition education and exercise as a weight loss strategy. It is implemented in small or large groups with meetings every one to two weeks over a sixteen week period. It is supplemented with presentations in specific nutrition topics and fitness topics that make it an effective program for reducing risk of cardiac, hypertension, and diabetic issues.
The Framingham Study Risk Factors
In developing a cardiac risk reduction program, the researchers at Patient Advantage looked to the gold standard of cardiac studies, the Framingham Study. This study, done over a two generation period, identified several risk factors that influence the chance of suffering from a heart attack. Some of these risk factors cannot be impacted by the Nurse Advocate directly and involve the Primary Care Provider. These factors include lipid profile, diabetes, hypertension, and others. In developing the Patient Advantage Challenge, five factors were identified that could be measured and documented by the Nurse Advocate. These five measurements are adequate to lower the risk of a first time heart attack by about 50%.
- Seeing the Primary Care Provider timely
- Taking medications properly
- Monitoring blood pressure frequently
- Exercising for twenty minutes five days per week
- Lose ten pounds
The Nurse Advocate will meet at regular intervals over a period of sixteen weeks with the participants in the Patient Advantage Challenge program and document all of these factors. Each meeting includes an updated weight measure, pulse measurement, updated record of exercise and review of medication compliance. A Myogauge test can be done, if appropriate.
Nutrition counseling program
A series of educational presentations are offered to help members make good nutritional decisions at home, at the grocery store and at restaurants. Based on the availability of the employee in the work setting, lessons are delivered in large group, small group, or individual settings. Employees that have specific nutritional questions or needs can see the Nurse Advocate one on one when the need arises.
In situations where a complex health behavior poses a risk to health, changing the behavior is a difficult and complex task. This includes morbid obesity, smoking, and unmanaged stress most commonly, but many other behaviors as well. People who face these challenges have likely suffered with them for many years and have many barriers; social, emotional, and physical, to making the change. Weight loss is a good example. Morbidly obese people most likely have been so for much of their lives. Barriers may include an aversion to exercise due to pain in the back or lower limbs, fear of dieting because food is a comfort item, menu planning that is being handled by an unsympathetic spouse or caretaker, or an emotional fear of failure. This is the type of case where trust in the Nurse Advocate is required, and the member’s perception of patience, empathy, and guidance on the part of the Nurse Advocate is paramount. Success is built around creating a workable program with a clear goal as the measurement of success made up of baby steps. Each step completed comes with the emotional support of the Nurse Advocate and the encouragement of moving on to the next step. This is Health Coaching at its best. With other clients we have been able to document the loss of as much as 103 pounds for one employee, changing his risk category as it related to obesity. This change could not have been accomplished without repeated face to face encounters over a long period of time. Equally important, these steps create a new lifestyle with better choices and healthier behavior to give way to a healthier life, not just a program to lose weight.
Employers converting to a High Deductible Health Plan /Health Savings Account
- Helping the member understand the concept and details of the plan
- Sharing of risk, responsibility of the member
- Discussion of the basis of insurance and managing greater personal risk.
- Accumulation of savings and financial impact of plan
- Discussion of
- tax leveraged savings
- tax deferred savings
- investment of savings
- rollover at retirement
- Likelihood of having a medical catastrophe
- Statistics of deductible use
- Reach out education to the providers in the area of the plan
- Advantages of the Health Savings Account patient
- Cash pay, no claim filing for payment
- Managing the paperwork for Health Savings account patients
- Clinical counseling for the members to anticipate the medical costs for the coming year
- Review of prior medical expenses
- Look at tax form and receipts of prior year
- Review of likely current year expenses
- Discussion of current illness, current medication, likely tests, imaging or events that will be incurred
We build the success of our program on developing trust between our nurses and the employees. Through regular worksite visits. We use a high percentage of engagement, real time information, and effective interventions to lower the cost of health care.
To learn more about how the Patient Advantage program can help your business, contact us.