NEW YORK, Nov. 9 /PRNewswire-FirstCall/ -- In a joint announcement, the State of Florida and Pfizer Inc said today that they have reached nearly 150,000 Medicaid beneficiaries and improved their health while providing the State savings and investment of $61.1 million through the Florida: A Healthy State program, their joint initiative launched in 2001.
The program, which provides innovative patient education and nursing care to high-risk, targeted Medicaid patients through a statewide network of community hospitals, civic organizations and patient advocate groups, cut the growth in Florida's medical costs by $41.9 million during a 27-month period ending in September 2003, according to Medical Scientists Inc., an independent organization that determined the results of the program. The State also received about $19.2 million in additional Pfizer investments and donated Pfizer medicines. In all, the program generated $2.18 of medical claims reductions for each dollar invested in the program.
"We are gratified by these results, which show very clearly that this innovative public-private partnership that modifies the healthcare system and engages patients actively in their own care decisions is delivering exactly what it promised three years ago: a practical, patient-centered solution that combines better medicine with better outcomes -- all at less cost," said Hank McKinnell, chairman and chief executive office of Pfizer. "We look forward to continuing to improve patient health and providing low-income Floridians with access to the best that modern medicine has to offer. The lessons we have learned in the past three years have important implications as both federal and state governments look for new ways to deliver better healthcare to patients with chronic diseases."
Initially planning to reach 50,000 patients, the program has reached nearly 150,000 beneficiaries with health education and triage services provided by registered nurses. The community-based health network created through the program links ten of the State's safety-net hospitals with dedicated care managers who provide individualized care to those patients at the greatest risk. In addition to care support, education and immunizations, Florida: A Healthy State has distributed more than 30,000 home health aids such as blood pressure cuffs, scales, and peak flow.
"At a time several years ago when Florida was looking to be a pioneer in developing meaningful strategies to reduce the growth in costs and improve health outcomes, Pfizer offered an innovative solution today delivering positive, measurable results well above our original objectives," said Alan Levine, Secretary of Florida's Agency for Health Care Administration. "The stories real patients are telling about this program are powerful reminders of the purpose behind Florida: A Health State. While cost avoidance is measurable and important, it is equally critical we improve lives and reduce dependency on sophisticated medical interventions in those cases where simply engaging the patient can make all the difference. Partnerships like this one with Pfizer are good benchmarks for states to use as they, like Florida, struggle with the difficult balance between cost and outcomes."
Care Managers Crucial to Better Outcomes for High-Risk Patients * In July of 2002, Nancy Rodrigues, RN, care manager from Memorial Hospital in Fort Lauderdale, contacted Jose G. on behalf of the program. "He was locked up in his home," Nancy said, "estranged from his family." Jose suffered a massive heart attack in the 1980s and is a diabetic. Two years later, by working with Nancy to monitor his blood pressure, improve his eating habits and control his blood glucose, Jose's heart condition has stabilized. His depression has subsided and he has reconnected with his family. "This program is the best thing that ever happened to me -- it saved my life," said Jose. "If it weren't for Nancy and Florida: A Healthy State I wouldn't be here." * Pierre J., a native of Haiti, is legally blind and fighting diabetes, hypertension, and asthma. Serrette Carling, care manager from Jackson Memorial Hospital, set up a support network of nurses, physicians, and community workers to help Pierre manage his health, improve his diet, and become more self-sufficient. Three years later, Pierre is well on the way to achieving his goals. His blood pressure and diabetes are under control and his asthma is improving every day. According to Pierre: "I didn't know how bad I was until I saw how good life could be again."
"I personally see the impact this program continues to have on the lives of real people in our community every day," said Michael L. Howell, MD, MBA, Diplomate, American Board of Internal Medicine of Orlando Regional Healthcare. "Patients are able to learn the tools necessary to adequately manage their chronic illnesses in ways that emergency rooms and acute inpatient hospital stays can never achieve. And it is because of the personal level of the training and the learning processes that this program is able to succeed."
With Education About Their Healthcare, Patients are Better Able to Manage Conditions and Change Their Health Behaviors
"As the program has grown over time, it has significantly increased its scale and impact. The number of high-risk patients under care management has tripled from the first to second year, and the results in terms of clinical improvements and cost savings have increased impressively," said Levine.
Florida: A Healthy State has successfully educated many patients about their diseases and healthcare, increased their abilities to self-manage, changed health-related behaviors, slowed the progression of chronic disease, and as a result, reduced utilization of high cost health services. Clinical and behavioral outcomes reported today include:
52% of patients showed improvement in their physical health score (the medically accepted measure of a patient's overall health as measured by the validated instrument, the SF-12(TM)), between baseline and most recent follow-up. 53% of patients improved their mental health score (as measured by the SF- 12(TM)), between baseline and most recent follow-up. 39% of patients improved their medication compliance score (as measured by the Morisky Medication Compliance Scale). 42% of heart failure patients improved their heart function after one year of care management (as indicated by an improvement in New York Heart Association classification). Diabetics increased their home monitoring of blood glucose, which contributed to an improvement in the patients' average blood glucose level. 50% of diabetic patients lowered their Hemoglobin A1c (measure of diabetes severity) after three months. The percentage of asthmatics who measure their peak flow at home doubled to 64% while the number of severe asthmatics dropped by 24.7%, between baseline and most recent follow-up. 40% of asthmatics improved their National Heart Lung Blood Institute (NHLBI) classification over a period of one year under management. Asthmatic patients reporting no symptoms increased by 45%.
These changes in health knowledge and behavior coupled with the support of the care managers helping patients find a medical home -- consistent physician care -- have been reflected in positive changes toward appropriate utilization of healthcare services:
* Physician visits for patients with Heart Failure increased by 13% while
patients reduced their emergency department (ED) visits by 19% and their
costly inpatient visits by 7%.
* Similarly diabetics increased physician visits by 2% while notably
reducing ED visits by 5% and reducing their inpatient visits by 17%.
* Hypertensive patients increased physician visits by 7%, reduced ED
visits by 8% and reduced inpatient visits by 4%.
"This partnership with the State of Florida, hospitals, physicians, and community organizations has provided clear and convincing evidence that a multidisciplinary approach to improving health outcomes can result in clear cost savings to Medicaid while significantly improving lives. We have all learned from our experience and continue working closely together to make the program even better," added McKinnell.
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