CHF Clinical Summary

How the Program Works | Facts You Need to Know | Compliance Management | CHF Outcomes

How the Program Works

Matria’s CHF Management Program provides specialized nurses who work with patients to recognize and control CHF symptoms that lead to the worsening of their condition, heart attacks, stroke, kidney failure and respiratory illnesses. Monitoring of fluid retention is an essential component of managing CHF, as heart failure causes excess water and salt to back up in the system, leak into the lungs and lead to respiratory illnesses.

Through educational materials and guidance from our nurses, we help patients take better care of their overall health to combat symptoms, such as fatigue, shortness of breath and swelling from fluid retention. By working with patients to alter their regular routines, we help them reduce disabling symptoms that result in absenteeism, presenteeism and a reduced quality of life. We encourage our patients and work with them to:

• Comply with prescribed medications to reduce fluids, lower blood pressure and/or improve circulation
• Develop a healthier diet of low-fat, low-cholesterol foods
• Avoid salt
• Lose weight
• Avoid caffeine
• Quit smoking
• Exercise
• Reduce stress
• Know when to seek medical treatment

Facts You Need to Know

Nearly 5 million Americans are living with heart failure, the nation’s leading cause of hospitalizations. CHF is the only major cardiovascular disease rising in both incidence and prevalence, with 4.8 afflicted Americans and 400,000 to 700,000 new cases diagnosed each year.

Preventable risk factors for heart failure include obesity, smoking, diabetes, CAD, COPD, hypertension, high blood cholesterol and lack of exercise. But there is a long list of nonbehavioral risk factors, including but not limited to past heart attacks, abnormal heart valves, heart muscle disease, heart defects at birth and viral infections.

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.

Compliance Management

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 congestive heart failure, we monitor the following:

• Usage of medications for circulation, blood pressure and fluid retention
• Usage specifically of ACE inhibitors to prevent kidney damage
• Monitoring of blood pressure
• Testing of blood fat content at least annually
• Cholesterol
• Lipids (HDL/LDL)
• Triglycerides
• Monitoring of salt, fluids and weight
• Annual flu shots
• Pneumonia vaccinations
• Aspirin usage

CHF Outcomes

Matria’s CHF Management Program produced the following results for a range of clients:

• Reduced hospitalizations by 29.5 percent and per member per month (PMPM) hospitalization costs by 14 percent
• Reduced emergency room visits by 27 percent and PMPM emergency room costs by 28 percent
• Reduced hospital days by 17 percent
• Reduced pharmaceutical PMPM costs by 9 percent
• Reduced total PMPM costs by 9.5 percent