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Disease Management Success Stories
Newly diagnosed diabetic A 35 year old was first diagnosed with new onset insulin dependent diabetes during a hospital admission following an urgent visit at his doctor's office where his blood sugar was 485. He weighed 300 pounds and his height was 5'10". He also had hyperlipidemia and was on medication for that. Prior to his hospital admission, he had been healthy. This gentleman lives alone. He works in an office. He does his own cooking. He stated that he had been heavy since childhood and that his doctor had told him that even losing a few pounds would help his medical condition. MedWatch provided coaching and information to the client especially regarding diet and exercise. His blood sugars had been running a bit low with a range of 75-95. His insulin was decreased to 30 units from the original 90 units. He was given education by MedWatch on low glycemic foods since he had been snacking on items from the vending machine. He was also given additional information on managing his diabetes and exercise. His A1C was 7.9% at his physician follow up visit. The goal is < 7%. His doctor stated that he was compliant with his treatment plan and medications. His doctor rated his diabetic knowledge as excellent. AK reported that he had been able to stay on his food plan and that he was walking for exercise. At a subsequent physician checkup, his A1C was 5.1 and his physician rated his diabetic knowledge as excellent. AK continued to do well. He was able to get off insulin and just be on oral medication for his diabetes. His blood sugar range was 85-105 and he was able to reduce the dosage of his oral medication. Hard savings: This saved the patient approximately $50.00/month out-of-pocket expenses for medications. Soft savings: Immeasurable.
Diabetic child with insulin pump A 5 year old boy with type 1 diabetes mellitus. He is in a very supportive family with 3 sisters. His youngest sister, age 6, was also recently diagnosed with type 1 diabetes mellitus. She is also in disease management. Her diabetes has been in better control than his. When this family entered disease management, they were having difficult time trying to take care of their son’s uncontrolled blood sugars. It was very hard for them emotionally and they were feeling frustrated trying to manage his blood sugars. His A1C on diagnosis was 10.3%. The parents told of a story how the kids played at a nearby park and the neighbors were feeding their kids candy (thinking they were being kind to the kids). The parents told how difficult it is to have two diabetic children, doing same diet, same exercise and with one being much harder to manage his diabetes. MedWatch gave them educational information, resources and local support groups for additional help. The family was very appreciative and even called MedWatch to give updates on the kids. The son’s most recent A1C was 8.9%. This is much better since diet and exercise do not seem to change his control. This patient’s mom had progressed emotionally in being able to cope with the kids’ diabetes management. The plan is to get an insulin pump for him and to prepare for that the family took pump classes together. One of the older daughters (age 9) is helping in the care of the diabetic kids and also educating others about diabetes. The family is now involved in multiple support groups including the tour de cure (a bike event at a local race track), selling baby beanies and wristbands for Juvenile diabetes research foundation, and a local support group of parents with diabetic kids. This is a good example of how the disease management holistic approach works, if your mind feels you can deal with a disease, i.e. you will be able to do it physically, emotionally, mentally and spiritually. Hard savings: Approximately $1,500.00 negotiated discount for the pump and supplies. Soft savings: Immeasurable.
Hypertension, diabetic plus deaf A 61 year old female who has a history of hypertension and diabetes mellitus. She is completely deaf. She smokes 1 pack of cigarettes per day and has for 25 years. On the health risk assessment, she checked that she had the following medical problems: diabetes, high blood pressure, stomach problems, TIA, cancer of breast/female organ, high cholesterol/triglycerides, hearing problems, female problems, breast disease, mental health/emotional problems, L4-L5 disc problems. She had not had recent well woman exams. MedWatch provided educational materials to her via mail and also information via email. On a subsequent physician check up her blood pressure was in the normal range at 110/60. MedWatch received a call from the HR Manager of the employer. She had known the patient for 35 years and had served as a patient advocate for her. She said the patient and her husband have many needs and she was glad that the benefit plan was providing the extra service of disease management. She also wrote a nice note which was faxed to the TPA. The TPA called to ask if we had marketing materials because they want to do some marketing with their groups about MedWatch services. The note from the HR manager said: “I was not aware of the MedWatch service—it is wonderful and I know that this person will benefit from your help.” Soft savings: Immeasurable.
Hemophilia child, mother learned to do the infusions Hard savings: Approximately $28,000 per bleeding episode. He had approximately 6-9 episodes per year.
Note: These savings do not reflect the additional savings of
previous hospital charges which were no longer needed. Gastric bypass surgery A 48 year old male with a history of morbid obesity, hyperlipidemia, diabetes, sleep apnea, arthritis of the knees and shoulders. Before gastric bypass surgery, he weighed 278 pounds. He is 5'10" tall. He stated that his main concern was his family history of obesity and complications plus his own high blood pressure and recent diagnosis of diabetes. He had been on various diet programs and had lost varying amounts of weight, but never more than 40 pounds. He always gained back the lost weight plus more. He also walked and rode a bicycle for exercise. He recovered well from surgery without suffering any complications. His blood sugar returned to the normal shortly after surgery. His blood pressure returned to normal at 120/77. He was able to eliminate his diabetic and high blood pressure medications. He was very motivated to do what he needed to do to lose weight and maintain the weight loss. He was doing about 30 minutes of cardiovascular exercises 4-5 times a week. He lost 85 pounds and weighed 195 (BMI 28). The Total Lifestyle Counselor provided education and support to the patient before and after surgery to help him make lifestyle changes so that he can stay as healthy as possible, to manage his medical conditions, and to avoid complications as well as unscheduled office visits, ER visits, hospitalizations. Hard savings: This saved the patient approximately $50.00/month out-of-pocket expenses for medications. Soft savings: Reduced future claims costs by avoiding unscheduled office visits, ER visits, and hospitalizations resulting from continued progression of his medical conditions.
Cardiovascular A 64 year old male who was admitted to the hospital via the ER with acute myocardial infarction and then had full arrest. He developed pulmonary edema. He was discharged on oxygen therapy. His weight was 330. He had a history of heavy alcohol usage and heavy cigarette usage. His blood pressure was 170/120. Prior to this, he had no previous history of myocardial infarction or congestive heart failure. MedWatch provided education and support to the patient and to his daughter who lived with him and was his primary support person. The patient stopped smoking and stopped using alcohol. He changed his diet. He completed the cardiac rehab program. He also bought a stationary bike and began riding that for a half hour every morning and afternoon plus walking. He has lost 40 pounds in 5 months. He discontinued the oxygen therapy and continued to lose weight. Hard savings: This saved the patient approximately $60.00/month out-of-pocket expenses for medications as well as the cost of cigarettes of approximately $45.00 per month. He had an additional savings for the oxygen therapy of approximately $100.00 per month. Soft savings: Avoidance of future medical claims costs by reducing risk factors.
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