Healthy
Solutions by Gateway Health AllianceSM
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High touch wellness/disease management for healthier employees
and a healthier bottom line. |
By educating
members on wiser utilization - not by reducing benefits - we have
helped our employer clients experience decreases in health plan costs.
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What is Disease Management? |
The Disease Management Association of America
(DMAA) has defined
Disease Management as:
“A system
of coordinated health care interventions and communications for
populations with conditions in which patient self-care efforts
are significant.”
According to the DMAA, a complete Disease Management program must consist of
six components (see below). Programs
consisting of fewer than all six components are only
considered support services for Disease Management programs.
Healthy
Solutions is Gateway’s
comprehensive corporate wellness and disease management
program. It is the core component of our approach to health
plan management. Healthy Solutions is high touch and
prevention oriented.
 The Good News: 80% of disease is
modifiable or preventable.
The future of managing the health care risks of
your employees and their dependents requires a comprehensive disease
management program – one
that incorporates all of the six components outlined by the Disease
Management Association of America (DMAA).
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Let's see how Healthy Solutions stacks up... |
Six Components of a Complete
Disease Management Program
(Disease Management
Association of America standards)
1. Population Identification Process
With the help
of Healthgram.com, Healthy Solutions uses medical data from six
different sources to identify members for intervention.
2.
Evidence-Based Practice Guidelines
Once members are identified and
stratified according to risk level, evidence based practice guidelines
determine the degree of intervention.
3.
Collaborative practice models to
include physician and support-service providers
Gateway’s physician Medical Directors
and support staff have developed our Care Management System, nurse training,
and Disease Management protocols according to AMA guidelines.
4.
Patient
self-management education
In addition to
online and printed self education tools, nurse care managers partner
one-on-one with members as personal health coaches.
5. Process
and outcomes measurement, evaluation and management
Gateway has a continuous process of
evaluating individual disease specific outcomes and a review of intervention
strategy and protocol effectiveness.
6.
Routine
reporting/feedback loop
Our extensive
reporting package includes population profiles, intervention tracking,
disease specific outcomes, and scheduled assessment reviews.
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Healthgram
combines data for Gateway nurses from six different sources in real time.
Real time data means early identification. Early identification means
early intervention, which usually results in cleaner, quicker, and more
cost-effective resolutions. |
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 Healthgram gives members:
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Personal E-health
record
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Access to claims history
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HRA risk indicators
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More than 1,500 condition-specific
informational brochures
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60-to 90-second educational videos
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How We Put It All Together |
1. Start Up
Includes identification of employees at risk through Health Risk
Assessment and Health Fair screenings; risk stratification, and enrollment
of Healthy Solutions participants.
2. Individual Intervention and
Ongoing Feedback
Nurse care managers (directed by physician Medical Directors) partner
one-on-one with at-risk employees to provide lifestyle and behavioral
counseling, coordination of health care services, and disease specific care
management interventions.
Integration with medical management process and claims data facilitates
continuous participant enrollment, risk restratification, and improvement.
3. Wellness
Deliverables
Monthly E-zine and other 24/7 online tools include healthgram.com;
disease specific member mailings, literature; printed periodicals.
4. Results
Reporting
Includes Population Profile, intervention tracking, disease specific
outcomes, and trends.
*Program PEPM Fees based on group size and package selected
**Nurse
Care Management fees billed in ¼ hour increments
***No
charge for reporting
Healthy Solutions
can be implemented alongside your current health plan
 Gateway Health Alliance works in close
partnership with the Wellness Coalition America (WCA), a leader in corporate
wellness and disease management. In conjunction with the
Wellness Coalition, Gateway is able to implement and deliver cost-effective
wellness and disease management programs for clients across the U.S.
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