Study Indicates HMO Program Improves Quality Of Life


Patients taking part in an innovative congestive heart failure (CHF) education and monitoring program in the Chicago area experience improved quality of life when following treatment guidelines, according to a recent study.

The year-long study, conducted for Humana Inc. by Cardiac Solutions, a subsidiary of Ralin Medical, Inc., showed that patients who followed the Humana program experienced 58 percent fewer emergency room visits than they had before the program was in place. The program is part of a partnership between Humana and Cardiac Solutions.

CHF is a progressive and often fatal disease of the heart afflicting mostly seniors, but is found among some younger people. Those with CHF must watch their diets, reduce physical exertion, and in some extreme cases, become bed ridden with the disease. More than 1,600 Humana members are enrolled in the CHF program in 15 Humana markets.

The study of 200 Chicago Humana CHF patients measured emergency room visits, hospital admissions and length of stay. The study also measured sodium intake and the resulting improvement in the health of the patient. Dr. Jerry Reeves, Humana corporate chief medical officer, says the results of the study are encouraging for CHF patients.

"Before the program was put in place, one in five CHF patients was admitted to the hospital at least once a month. Now, that number has dropped by 58 percent," says Reeves. "That's significant because it means the home-based, physician-directed and nurse-monitored program is working. More importantly, it means the patient's quality of life has been enhanced dramatically."

Success stories are also being told in other areas of the country where Humana and Cardiac Solutions have implemented the program. For Maria Ferrell, just getting out of a chair and walking to the front door of her Corpus Christi, Texas home is difficult. Often, she would have to go to the emergency room or even stay a few days in the hospital just to get her condition stabilized.

"The program has been very good for me to learn more about what to eat and not eat, especially salt and cholesterol," says Mrs. Ferrell. "They even gave me some ideas on how I can get much needed exercise without having to leave my house."

"In another case in Corpus Christi, one of our CHF patients was averaging two emergency room visits per month," says Dr. Reeves. "When the Cardiac Solutions nurses helped the family change the patient's diet, the visits were no longer necessary and the patient's quality of life improved. It's amazing what education and understanding can do for patients."

The Chicago study shows other positive results for members as well. After only one year in the program, the level of sodium in an average study patient's diet decreased 15 percent.

"Just opening and consuming a can of high-sodium soup can send a CHF patient to the emergency room," says Dr. Reeves. "Following the nurse case manager's advice translates into better control over CHF and certainly improves the patient's lifestyle."

That's where the role of the Cardiac Solutions nurse is invaluable, according to Dr. Reeves. "Nurses will often call patients to help set up appointments, make referrals for other needed services, monitor their condition and continue the in-depth educational process that is essential to the success of the program." Home health nurses also pay visits to the patient's home when necessary to ensure all medications are being taken properly and to answer the family's questions about exercise and diet.

Humana Inc., headquartered in Louisville, Ky., is one of the nation's largest publicly traded managed health care companies with approximately 4.8 million health plan members primarily located in 17 states.

More information about Humana is available at: http://www.humana.com.

Cardiac Solutions is a subsidiary of Ralin Medical, Inc. and is the nation's leading provider of cardiac disease management services focused on the care of high-risk, high cost patients.


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