What It Is:
Control of chronic diseases, such as diabetes, is the key to keeping an employer’s healthcare costs under control. ACTRx is a simple, cost-effective way to tackle this challenge.
First proven effective in Asheville, North Carolina, this patient centered program focuses on improving the lives of your employees or covered family members with diabetes, and ultimately help control the spend and either improve or stabilize their health. The healthcare savings, reduced absenteeism and improved health of participants realized in the Asheville model led to the launch of the program here in Central Pennsylvania.
What began as the Bridge Project in 2006, morphed into ACTRx in 2012 as the program continued to grow and change to meet the needs of our employer members. Today, the Central Penn Business Group on Health partners with Penn State Health Community Medical Group - Lancaster Diabetes Center to bring this unique program and its exciting benefits to employers in the Central Pennsylvania region.
How It Works:
Participants in the program are each assigned a Diabetes Nurse Educator (DNE) who acts as the patient’s designated disease management “coach” in face-to-face meetings.
The DNE’s, with support from the Physicians at Penn State Community Medical Group – Lancaster Diabetes Center develop individual treatment plans with each patient’s primary care physician. The DNE follows a consistent regimen of education, monitoring, data collection and coaching with each patient and communicate progress of the patient to their primary care physician. Participating employers also receive de-identified summary results for their covered employees and or family members.
Through the coaching process, program participants learn how to better manage their disease with the goal of stabilizing their health and reducing the chances of further deterioration. In addition, participants who volunteer for the program receive incentives that may include waived or reduced copays for their medicines, lab tests, and supplies needed to treat their disease. Patients do not have to change their existing prescription programs (even mail order), and they do not have to fill their medicines or purchase their supplies through the program. All coaching is done onsite at the workplace at pre-arranged meeting times.
Why It Works:
Studies show that only about 50% of people take their medications as directed and poor adherence to medication therapies prevent patients from receiving the full therapeutic benefit of the medications – this is a critical issue for patients with chronic diseases such as diabetes and can lead to significant health risks and high healthcare costs for employers. The overall healthcare costs of poor medication adherence have been estimated to approach $100 billion each year.
ACTRx is a HIPAA-compliant, proactive program that addresses the issue of medication adherence and provides education to the patients through face-to-face coaching by a trained Diabetes Nurse Educator working with the patient’s primary care physician.
ACTRx is a completely freestanding program that does not require employers to change healthcare plans or purchase specific products to participant. It is available to any employer in the region and is designed primarily for employers that self-fund their benefits. There are no mandatory minimum or maximum patient enrollment levels for employers and each employer sets their own parameters for their program.
What Are The Outcomes:
ACTRx is a proven way to improve the health of your employees and your bottom line!
Employers invest in the program with minimal monthly administrative fees and ongoing fees for the one-on-one coaching. Additionally, any waived copays will slightly increase health plan costs. However, the health plan savings realized by the employers outweigh these costs. In addition, patients in the program have realized stabilization or improvement in their health and well-being.
Annually, employers receive clinical and economic analysis and reports on the patients in the program.
How Do I Enroll My Employer?
To enroll in ACTRx, you must be a member of the Central Penn Business Group on Health. Once you are a member, you can reach out to Diane Hess, at CPBGH by calling (717) 239-6954 or via email at firstname.lastname@example.org