CAD Clinical Summary

How the Program Works | Facts You Need to Know | Self-Management Strategy | Compliance Management | CAD Outcomes

How the Program Works

Matria's CAD Management Program provides specialized nurses to help employees comply with their medication and treatment plans and change unhealthy lifestyle behaviors that negatively impact patient progress. Our goal is to help patients fully understand the serious health effects from not adhering to care plans.

Clinicians also work with patients to recognize and control CAD symptoms that lead to the worsening of their condition, heart attacks, stroke and heart failure. As a result, CAD patients require fewer hospitalizations and costly treatment procedures, such as angioplasty and bypass surgery. They are more productive at work and experience an improved quality of life.

Facts You Need to Know

Coronary artery disease is the leading cause of death in the United States. Expected to cost $133 billion in 2004, about 13 million Americans suffer from the disease. About 1.1 million Americans suffer from a heart attack each year, with roughly half of them fatal.

Preventable risk factors for heart disease include obesity, smoking, diabetes, hypertension, high blood cholesterol and lack of exercise. Nonpreventable risk factors include a history of heart disease in the family, aging and gender. Women are less at risk to develop heart disease until after menopause.

Heart failure is an exploding area of healthcare. By 2030, estimates predict that 6 million people will have the disease, driving the annual costs to $38 billion or 5.4 percent of the total healthcare budget.

Patient Self-Management Strategy

Our program is designed to help patients comply with their doctor’s plan of care, which involves several key clinical performance indicators based on national standards. While working with patients, we track their adherence to these standards and report back measurable results to show program impact on patient compliance. For patients with coronary artery disease, we monitor the following:

• Comply with medications and their doctor’s plan of care
• Lower their blood pressure
• Control cholesterol level with low-fat diet
• Lose weight and control overeating
• Stop smoking
• Exercise to tolerance
• Reduce and improve management of stress
• Recognize early symptoms of a heart attack and what to do about it
• Learn treatment options

Compliance Management

We develop individualized programs for each patient that monitor our program’s impact on their CAD “report card.” We track, measure and report on the following clinical performance indicators as a way to monitor the patient’s progress:

• Usage of blood pressure medications, including beta blockers prescribed after heart attacks to prevent future episodes
• Testing of blood fat content at least annually
• Cholesterol
• Lipids (HDL/LDL)
• Triglycerides
• Blood pressure monitoring
• Annual flu shots
• Pneumonia vaccinations
• Aspirin usage to prevent heart attacks

CAD Outcomes

Matria's CAD Management Program produced the following results for a range of clients:

Cost Savings:

• Reduced hospitalizations by 24 percent and per member per month (PMPM) costs by 17.5 percent
• Reduced ER visits by 17 percent
• Reduced PMPM medical costs by 12 percent
• Reduced pharmaceutical PMPM costs by 6 percent
• Reduced total PMPM costs by 12 percent

Clinical Performance Indicators:

• Increased LDL screenings by 13 percent
• 40 percent of LDL test results within target range