PMID- 22471165
OWN - NLM
STAT- MEDLINE
DCOM- 20120510
LR  - 20220408
IS  - 1062-3388 (Print)
IS  - 1062-3388 (Linking)
VI  - 21
IP  - 3
DP  - 2012 Mar
TI  - Clinical and economic outcomes of the Cincinnati Pharmacy Coaching Program for 
      diabetes and hypertension.
PG  - 44-54
AB  - PURPOSE: Value-based insurance designs (VBID) have been developed by health 
      insurance companies and used by employers to allocate health care resources 
      appropriately and to lower patients' out-of-pocket costs for services related to 
      chronic conditions. The purpose of this study was to evaluate the effect of the 
      Cincinnati Pharmacy Coaching Program (CPCP) on clinical and economic outcomes. 
      The CPCP is a VBID implemented by Anthem Blue Cross & Blue Shield in Ohio. It 
      provided tailored pharmacist-based educational services and financial incentives 
      to participants. METHODS: This was a quasi-experimental pre/post longitudinal 
      study in which patients were identified as they enrolled in the CPCP between Jan. 
      1, 2008, and Dec. 31, 2009. Patients could participate in a Diabetes Coaching 
      Program (DCP) or a Heart Healthy Coaching Program (HHCP). Control subjects were 
      selected from patients who were invited but did not choose to participate. 
      Control subjects were matched to intervention cohorts using propensity score 
      matching. Clinical (blood pressure, lipid levels, and hemoglobin A1c) and 
      economic (all-cause and disease-attributable) outcomes were evaluated using 
      within-subject (pre-post) and between-subject comparison (intervention-control) 
      design. RESULTS: A total of 607 patients were enrolled in intervention groups, 
      and 557 control subjects were selected after matching. Significant reductions 
      were found in blood pressure, lipid levels, and hemoglobin A1c after enrollment, 
      and a significantly greater proportion of patients, compared with controls, 
      achieved their clinical goals according to national guidelines in both programs. 
      Hypertension-related cost trends were favorable for HHCP relative to the control 
      cohort. Diabetes-related costs increased for all groups from pre- to post-index, 
      largely driven by office visits and medication costs in the DCP and inpatient/ER 
      visits in the control cohort. CONCLUSION: Results showed significant improvements 
      in all diabetes- and hypertension-related clinical measures. This study shows the 
      effect of a comprehensive VBID on the health of patients with chronic disease.
FAU - Wertz, Debra
AU  - Wertz D
AD  - HealthCore, Wilmington, DE 19801, USA. dwertz@healthcore.com
FAU - Hou, Likun
AU  - Hou L
FAU - DeVries, Andrea
AU  - DeVries A
FAU - Dupclay, Leon Jr
AU  - Dupclay L Jr
FAU - McGowan, Frannie
AU  - McGowan F
FAU - Malinowski, Barry
AU  - Malinowski B
FAU - Cziraky, Mark J
AU  - Cziraky MJ
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Manag Care
JT  - Managed care (Langhorne, Pa.)
JID - 9303583
MH  - Case-Control Studies
MH  - Diabetes Mellitus/*drug therapy
MH  - Disease Management
MH  - Female
MH  - Health Education/*organization & administration
MH  - Humans
MH  - Hypertension/*drug therapy
MH  - Insurance, Health, Reimbursement
MH  - Longitudinal Studies
MH  - Male
MH  - Managed Care Programs/economics/*organization & administration
MH  - Medication Adherence
MH  - Middle Aged
MH  - Ohio
MH  - *Outcome and Process Assessment, Health Care
MH  - Patient Selection
MH  - *Pharmacists
MH  - Reward
EDAT- 2012/04/05 06:00
MHDA- 2012/05/11 06:00
CRDT- 2012/04/05 06:00
PHST- 2012/04/05 06:00 [entrez]
PHST- 2012/04/05 06:00 [pubmed]
PHST- 2012/05/11 06:00 [medline]
PST - ppublish
SO  - Manag Care. 2012 Mar;21(3):44-54.