PMU68 BCBSLA EVALUATION OF A NURSE FOCUSED DISEASE MANAGEMENT PROGRAM IN LOUISIANA

Abstract

Disease management (DM) programs introduced by Blue Cross Blue Shield of Louisiana (BCBSLA) employed a large group of nurses to identify the high risk chronic disease individuals and work directly with these patients. This research focuses on whether the nurse focused DM program improved enrollee intermediate health outcomes and/or decreased health care spending. This retrospective observational study used BCBSLA claims data from March 2015 to February 2018. The study population includes all BCBSLA members with at least one of the following chronic conditions: asthma, COPD, CHF, hypertension, diabetes. Members newly enrolled from March 1st, 2015 - February 28th, 2018 were included if (1) directly contacted by phone at some point during the study period, (2) under the age of 65 at the time of enrollment, (3) did not have a record for those chronic conditions on any claim before January 2015, and (4) not having pre-diabetes, ESRD or rare conditions. General Linear Regression Models were created by three time intervals (1-12 months, 13-24 months and 25-36 months) respectively. Savings attributable to the DM program were based on difference-in-difference analysis of trends calculated through the model. 5,591 patients with at least one chronic condition (asthma, COPD, CHF, hypertension, diabetes, or chronic kidney disease) at the beginning of 2015 and enrolled in the DM program at some point between March 2015 and February 2018 were included in this study. Preliminary model results showed reductions in medical cost per member per year: Year 1: $396; Year 2 $1,295; Year 3 $1,406. A significant reduction in healthcare expenditures was found when disease management programs are utilized for patients with chronic diseases.