Benefits leaders for the State of North Carolina's health plan - which covers state employees as well as teachers - have implemented successful disease management programs, which not only have helped improve population health, but have also buoyed the company's bottom line.

Due to the success of its disease management programs, the state has been able to reduce cost-shifting to employees for 2014.

"Over the past five years, we've had a dramatic turnaround in our financial situation," says Mona Moon, the executive administrator of the State of NC Health Plan. She credits chronic disease management with helping the organization climb out of a financial hole.

"We have recommitted ourselves to population health management programs. They are now an integral part of the plan, and we're increasing incentives to increase our engagement," says Moon.



Health assessment use

The program culls claims data and members' self-identified health assessment data through the state health plan's population health management vendor, ActiveHealth, which identifies and reaches out to members who are high-, medium- and low-risk regarding their health conditions.

Of the 28 different clinical metrics that ActiveHealth measures, the state's health plan has seen improvements in 22 metrics since 2012.


'Something for everybody'

The state's health plan has a diverse membership, but it aims to "have something in there for everybody," says Lotta Crabtree, interim deputy executive administrator and director of contracting and legal compliance for the State of NC Health Plan.

As such, the plan offers tools for health tracking, access to health coaches, a Quitline program for smoking cessation, and an Eat Smart, Move More, Weigh Less program that helps individuals lose weight.

In order to imbed wellness activities deeper into the population, the State Health Plan trains employee-volunteers to take the lead on wellness education for colleagues at their worksite.

The organization is also starting a pilot program to increase physician awareness of NC HealthSmart, an online healthy living resource for plan members and their families, so they can pass the information on to employees. "Our hope is that when the invitation to participate comes from a trusted source, the member's physician, they are going to listen and perhaps have a better level of engagement," says Crabtree.



High engagement

So far member engagement among contacted participants is soaring and has reached 86% across all programs. Engagement has reached over 96% in the maternity coaching program, which waives mothers' copays if they deliver at a network hospital. Participants must engage with a health coach before they are 20 weeks along and have a follow-up appointment after the birth.

Close to 80% of the participants in Step Up Carolinas, a statewide walking program that engaged people across North Carolina, were from the state health plan, says Wadida Murib-Holmes, executive director for ActiveHealth Management.

Overall, employees experienced a 14% reduction in risk factors, according to the state's 2012 annual report. Here are some highlights:

* Blood pressure risks reduced 21%.

* Cholesterol risks reduced 31%.

* Weight reduced 2%.

* Smoking reduced 1%.

* Overall physical activity increased 41%.

* Seatbelt use increased 49%.

* 53% of employees perceived their health positively.

No matter what path an employer's wellness program takes, benefits managers shouldn't expect an overnight journey, but a years-long road trip to successfully ingrain initiatives in company culture, center wellness strategies as part of core business imperatives and fully engage participants.

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