wei Aetna’s Innovative Health Information Technology Enables Life-Saving Solutions

 Dr. Henry Wei, Senior Medical Director

 Aetna: Preventing Dangerous Drug Interactions
Neither David nor his doctors were aware that his migraine medication and his prescription for coronary disease could have a life-threatening interaction. The CareEngine identified the problem, and Aetna immediately notified David and his doctors so they could find a safe alternative. 

Aetna: Supporting the Practice of Evidence-Based Medicine
The CareEngine makes doctors aware of the latest scientific evidence to support effective patient care.

Aetna: Identifying and Addressing Serious Health Risks 
When the CareEngine notified a patient and his doctor that he was at risk for a burst artery, he received care in time to prevent it from happening. CareEngine can reduce costs by improving health outcomes. A study of 40,000 patients found that the CareEngine reduced hospitalizations by 8 percent and lowered overall health care costs.
amg  Amerigroup: Coordinated Case Management
Amerigroup works with the State of Tennessee and community partners to coordinate long-term care services for elderly and disabled Medicaid members in their own homes. Larry was first in Tennessee to return home under this program.
a  Amerigroup: Dedicated Doctors and Nurses
One in eight babies in the U.S. is born too soon, a leading contributor to the nation's high infant mortality rate.To address the problem, Amerigroup created the "Taking Care of Baby and Me®" program for prenatal and postpartum care.
bcbs  BCBS Massachusetts: The Alternative Quality Contract
Blue Cross Blue Shield of Massachusetts has developed a new approach to paying for health care, The Alternative Quality Contract, which is intended to improve the quality of care that patients receive and slow the rise in health car costs. Doctors and hospitals are rewarded for keeping patients healthy and for effectively managing chronic illnesses.
Cigna: A Cigna Member with Diabetes Tells How the Health Plan's Wellness Program Turned Her Life Around

Working closely with patients, their families, and other health professionals, Cigna's case managers help patients access the medical, behavioral, health, and social services they need. They also educate patients about their health conditions and provide coaching to help them reach personal health goals.

Cigna: A Cigna Member Tells How the Health Plan Helped Her Following a Car Accident

Working closely with patients, their families, and other health professionals, Cigna's case managers help patients access the medical, behavioral, health, and social services they need. They also educate patients about their health conditions and provide coaching to help them reach personal health goals.
 Nemecek Cigna’s Health Coaching and Employee Assistance Programs Help People Live Better Lives

 Dr. Doug Nemecek, Senior Medical Director

 Cigna: How Health Coaching Works
Cigna connects members to health coaches with the expertise to help them with their individual needs and health goals. 

Cigna: Coaching a 9/11 Survivor for Better Health
Cigna’s health coaches helped a former New York City police officer who was suffering post-traumatic stress enter treatment for his drinking problem and access care for his lung and kidney disease. 

Cigna: Going Smoke-Free and Shedding Pounds Before Pregnancy
A young woman getting ready to start a family wanted to quit smoking and lose weight. Cigna’s health coach helped her make the lifestyle changes needed to reach her goals.

Cigna: Getting on the Right Track with Weight Loss, Diabetes, and Depression
Cigna’s health coaches helped patients who felt “stuck” make progress in losing weight, managing diabetes, and overcoming depression. 

Cigna: Finding Food for a Sick Child
When a woman on disability had no money to buy food for her sick child, the EAP counselor found a food bank near her house that could give her food for the next day.

Cigna: Enabling a Victim of Domestic Violence to Begin Rebuilding Her Life
When a woman suffering in an abusive relationship didn’t know where to turn, Cigna’s EAP counselor guided her to the support she needed to move forward.
Kolbasovsky EmblemHealth’s Case Management Program Provides a Safety Net for Medicaid Beneficiaries

 Dr. Andrew Kolbasovsky, Director of Provider Group Clinical Management

 EmblemHealth: Overcoming Alcoholism and Addressing Unmet Medical
An EmblemHealth case manager built a trusting relationship with a member who was an alcoholic and helped him enter an alcohol treatment program. Now that he is sober, he is addressing his other medical conditions and having regular preventive care screenings. 

EmblemHealth: Finding Creative Ways for a Patient to Afford Treatment
When an EmblemHealth case manager learned that a patient with diabetes was not taking his medicine due to the cost, she provided him with free needles and connected him with a pharmacist who worked with his doctor to design an affordable treatment plan.
 Travisano EmblemHealth Nurse Case Managers Provide a Personal Touch To Put Patients on a Path Toward Better Health

 Anne Travisano, Senior Director, Medical Management

 EmblemHealth: Reaching Out to Patients with Complex Conditions
EmblemHealth’s nurse case managers form special bonds with patients who have complex conditions, checking in on them regularly and supporting them as they work toward their health goals.
 Chitre Excellus Blue Cross Blue Shield Works with Patients and Doctors to Keep Medication Regimens Safe and Affordable

 Dr. Mona Chitre, Director of Pharmacy

 Excellus Blue Cross Blue Shield: Protecting Patients from Adverse Drug Interactions
Upon discovering that 15 patients with breast cancer were taking antidepressants that could interfere with the effectiveness of their breast cancer medications, Excellus Blue Cross Blue Shield took immediate action to keep them safe. 

Excellus Blue Cross Blue Shield: Keeping Medications Affordable
Excellus helped a patient with multiple chronic conditions afford the medications she needed. 

Excellus Blue Cross Blue Shield: Overcoming Confusion about Medications after a Hospital or Rehab Stay
Patients discharged from hospitals or rehab facilities are confused when they return home with bags of new medications. They don’t know whether to take their old medications, their new medications, or both. Excellus Blue Cross Blue Shield pharmacists help them sort through the maze.
ghc  Group Health Cooperative: Living Well with Chronic Conditions
Through Group Health's Living Well with Chronic Conditions program, patients with chronic conditions participate in six-week group workshops in person or online to gain support and learn how to manage their conditions effectively.
ghc2  Group Health Cooperative: The Medical Home
Members of Group Health Cooperative receive primary care through the Medical Home initiative. Physicians lead teams of nurses, clinical pharmacists, physician assistants, and case managers to address all of patients' preventive, acute, and chronic care needs.
 Courneya HealthPartners Gives Patients and Doctors Many Tools To Improve Diabetes Care

 Dr. Pat Courneya, Medical Director

 HealthPartners: Empowering Patients with Diabetes to Improve Their Health
After Dr. Courneya connected one of his patients with HealthPartners’ disease management program, the patient took charge of his health, participated in a workplace weight loss program, lost 40 pounds, and felt much better about himself. 

HealthPartners: Coaching Patients on Reaching Goals for Better Health
HealthPartners’ nurse health coaches check in regularly with diabetes patients, help them manage their complex medical regimens, and offer tools and support for making healthy lifestyle change.

HealthPartners: The Diabetes Wizard
HealthPartners’ online decision support tool, the Diabetes Wizard, helps physicians provide optimal care for patients with diabetes.

HealthPartners: Achieving Results that Make a Difference for Diabetes Patients
HealthPartners’ diabetes initiatives are helping hundreds of patients each year avoid life-altering complications.
humana  Humana: Humana Cares
The Humana Cares program goes beyond traditional disease management. Humana Cares staff provide extensive, one-on-one support, both in person and by phone, to improve the health status and quality of life for patients with complex and chronic conditions.
 Eckardt Independence Blue Cross’s Medical Home Program is Revitalizing Primary Care

 Pamela Eckardt, Director of Clinical Care Transformation

 Independence Blue Cross: Teaming Up to Address Patients’ Many Needs
Independence Blue Cross’s doctors, nurses, medical assistants, and pharmacists work together to make sure that patients have the lab tests, primary and specialty care, and personal support they need to live healthy lives.

Independence Blue Cross: Enabling Doctors and Nurses to Realize their Goals for Excellence 
The Medical Home Model allows doctors and nurses to provide the high-quality care they originally envisioned when they entered the medical profession.
Weissberg Kaiser Permanente Provides Tools to Support Healthy Lifestyle Change

 Dr. Jed Weissberg, Senior Vice President for Hospitals, Quality, and Care Delivery

 Kaiser Permanente: Using Web-Based Learning and Social Media to Help Patients Lose Weight
Kaiser Permanente’s online learning modules and social networking site help members reach their goals for fitness and weight loss. 

Kaiser Permanente: Making Exercise a Vital Sign
Exercise is now a “vital sign” for all Kaiser Permanente members. While they have their weight, height and blood pressure measured before a doctor visit, patients are asked how often they exercise so that doctors can follow up.

Kaiser Permanente: Offering Culturally Sensitive Counseling for Weight Loss
Kaiser’s health care teams and nutritionists are familiar with the many cultures in their communities, and they take cultural preferences into account when making nutrition recommendations.
Molina  Molina: Shots for Shorties and Check Up or Check Out
Molina's Shots for Shorties program provides outreach and incentives to improve immunization rates among African American children in Detroit. From the time of the program's launch in 2004 to 2010, the percent of children under age 2 who received recommended immunizations rose from 38.3 percent to 70.2 percent.

In 2006, Molina Healthcare partnered with the Michigan Department of Community Health to create the Check Up or Check Out program to encourage African American men to have annual preventive care visits. From 2006-2010, rates of cholesterol and blood glucose testing, as well as colorectal and prostate cancer screening, more than tripled.
SCAN  SCAN Health Plan: A Better Way to Care
SCAN Health Plan serves more than 130,000 seniors and the physically disabled in California and Arizona. Nurses and social workers arrange for all of the medical, social, and behavioral health services that beneficiaries in SCAN's Special Needs Plans (SNPs) need to live safely in their own homes.
Sentara  Sentara/Optima Health: The Wellness Payoff
In 2008, Sentara Healthcare implemented an incentive-based health and wellness program for employees. Over the past two years, health indicators for participating employees have improved significantly, and the program has achieved a net savings of $3.4 million.