CAPP Physician Group: KAISER PERMANENTE
Project: AVIVIA HEALTH POPULATION MANAGEMENT PROGRAM:

Summary: Kaiser Permanente’s Avivia Health’s population management program leverages extensive historical population data to tailor outreach programs for employees with chronic illness to help them play a more proactive role in their own health care through coaching and health education. Initial trial in Georgia saved $7.5 million.

Kaiser Permanente recently launched Avivia Health (AH), which offers customized population management programs to employers to improve quality and financial outcomes, and to help employees and their dependents become better informed and engaged health care consumers.

Tested in Georgia, Avivia Health is an integrated suite of evidence-based care management programs for acute and chronic conditions that can be tailored to the characteristics of employers/purchasers and their beneficiaries. The goal is to empower the patient and reinforce the patient/doctor relationship. Through AH, patients play a more active, collaborative role in their healthcare and are enticed to take charge of their health.
Once an initial analysis of historical data and predictive modeling is conducted, areas of opportunity within an employer’s covered population are identified. A customized outreach campaign is then created to engage employees to participate, a step that can dramatically impact the overall effectiveness of the health care outcome.

Once involved, employees and their dependents can take advantage of 24/7 telephone health coaching (in multiple languages) and receive multi-channel support for their health concerns through Interactive Voice Recognition (IVR), web, DVDs, and print materials. Health education services are available for everything from nutrition, weight loss, smoking cessation, and stress reduction, to self-care and decision support for a variety of conditions.
In return, Avivia Health customers--which include large, national, self-funded employer groups/plan sponsors, and labor and trust unions--receive monthly activity reports for their employee population that provide an overview of the program, milestones, performance, and a rolling 12-month view.

An evaluation of AH during its first year in Georgia yielded positive results in clinical quality indicators, patient satisfaction, and financial return. Costs savings were in excess of $7.5 million. An independent third-party surveyed more than 500 participants, roughly half of whom had one or more chronic conditions. Of those surveyed, 87% were satisfied with the assistance they received from health coaches. Specific benefits that patients noted included improved ability to talk to their doctor (72% of users), improved quality of care (86%), and improved ability to manage their own condition (74%).

For more information about this project, please contact Nancy Taylor, The Permanente Federation, at (510) 271-6995.

Integrating Services for Low-Income Seniors Shows Health Care Benefit, by Claire Sowerbutt, Contributing Writer, MedPage Today, December 11, 2007.

INDIANAPOLIS, Dec. 11 -- For low-income seniors, the likelihood of providing the recommended standard of health care services could be enhanced by integrating home-based and institutional services, found researchers here.

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“From High Tech to Soft Touch: The Everett Clinic uses innovative ways to control health care costs,” by Bryan Corliss, Washington CEO, November 26, 2007.

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“CAPP’s 35 MSMGs [multispecialty medical groups] share a common vision as learning organizations dedicated to the improvement of clinical care. Their features include physician leadership and governance; commitment to evidence-based care management processes; well-developed quality improvement systems; team-based care; the use of advance clinical information technology; and the collection, analysis, and distribution of clinical performance information. These features are congruent with the [Institute of Medicine’s] recommendations on key elements needed to redesign delivery systems.”

From Chapter 5, “Developing the Test Bed—Linking Integrated Service Delivery Systems: Council of Accountable Physician Practices,” by Michael A. Mustile, MD. The Learning Healthcare System: Workshop Summary (IOM Roundtable on Evidence-Based Medicine), edited by LeighAnne Olsen, Dara Aisner, and J. Michael McGinnis, National Academies Press, 2007.

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“A shift from the current care model to a more coordinated care model centered on primary care is one potential way to help stave off the healthcare dilemma.”

“It's too expensive to be a primary-care doctor,” by Debra A. Geihsler, president and CEO of Harvard Vanguard Medical Associates & Atrius Health. Boston Globe, July 25, 2007.

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