Pfizer and Florida’s Agency for Health Care Administration
Florida: A Healthy State
Florida: A Healthy State is a ground-breaking disease management public-private partnership between the State of Florida’s Agency for Health Care Administration (AHCA) and Pfizer. Pfizer and Florida created a new health partnership with community hospitals, consumer advocacy groups, physicians, and participants to provide new health benefits and improve the health of at least 50,000 Medicaid beneficiaries. The goal of the program is to improve the health of chronically ill Medicaid beneficiaries while reducing healthcare costs for the state as well s to prove that changes in health behavior lead to improvements in clinical measures—resulting in changes in utilization and overall financial savings to the state.
The program focuses on the health of patients suffering from diabetes, hypertension, asthma and heart failure. It uses hospital based care managers stationed at 10 community hospitals across the state (and one remote call center) to provide the information and support necessary to help participants make informed healthcare decisions. The program educates patients so they can better understand and manage their own disease, follow their physician’s treatment recommendations and to stay healthier. Participants also have access to a 24/7 nurse hotline for after-hours advice and support. Beneficiaries are encouraged to consistently seek care in physicians’ offices rather than via costly visits to the emergency department (ED) or hospital.
In 2004, OPPAGA analyzed value added programs and subsequently the legislature concluded that Florida should not continue to engage in value added contracts in lieu of supplemental rebates from pharmaceutical companies. Pfizer and AHCA have created a transition program together to ensure continuity of care for needy Floridians with chronic disease. Florida is planning to roll out a Medicaid reform program in two years that employs many disease management strategies espoused by the Florida: A Healthy State program.
Results (2003-2004):
- The Healthy State program has distributed over 640,000 educational pieces and more than 35,000 home-health devices to help patients self-monitor at home.
- Better control of chronic conditions led to more efficient utilization of healthcare resources, such as ED and hospital admissions.
- People with heart failure reduced their ED visits by 18% and their costly hospitalizations by 22%.
- Asthmatics reduced their ED visits by 12% and hospitalizations by 23%.
- Participants with high blood pressure reduced their ED visits by 11% and reduced hospitalizations by 31%.
- Overall, ED utilization was reduced by 12% and hospitalizations fell by 28%
- Clinical and behavioral metrics include:
- Peak flow monitoring among the asthmatic population nearly doubled to 63% at follow-up compared to only 32% at baseline
- Daily weight monitoring among heart failure participants increased to 46.2% compared to only 12.7% at baseline.
- Participants who monitored blood glucose at home grew from 87.8% to 93.2%
- Diabetics with normal blood pressure increased by 26% from baseline to the most recent follow-up. Improvement was seen as early as 6 months after entering care management.
- Only 50% of diabetics had an HbA1c value at baseline compared to 71% at most recent follow-up
- Participants with diabetes, hypertension and/or heart failure (asthmatics were not included), who knew their total cholesterol numbers, increased 42.6% (from 47% to 67%) at most recent follow-up. Participants who followed a special diet increased by 19%.
- Medication compliance improved 21%.
- Physical and mental health scores improved in all follow-up periods and all disease states showed higher scores at most recent follow-up.
- Participants who exercised increased by 7% at most recent follow-up.
***Submitted by Larry Fields, Larry E. Fields, MD, MBA, FAHA, FACC, Senior Director, Strategic Policy Worldwide Public Affairs & Policy, Pfizer Inc., Larry.Fields@pfizer.com
Published: January 26, 2009
