Summary of Wellness Recommendations University of Kentucky Health Care Task Force

Summary of Wellness Recommendations
University of Kentucky Health Care Task Force
November 2001
Recommendation: Integrate Prevention and Wellness with Health Plan Operations.
 Integrated assessment tool – Provides the health plan with self-reported
information on the risk profile of the population. Requires secure portal web
access for faculty and staff, kiosk technology for parts of campus and a presence
within the physician office setting. Should be on a standard database platform so
we can integrate the prospective risk information with the retrospective claims
information. This will allow us to identify the high risk/conditions and focus our
preventive efforts on the most advantageous areas.
 Marketing/Detailing – In conjunction with the College of Pharmacy, we should
develop a ‘sales strategy’ for the KY Clinic. This strategy will include physician
education on formulary and pharmaceutical issues, behavioral interventions,
patient risk profiles and feedback on ‘best practice’ patterns. Additionally, a
broad marketing effort to the plan members should be undertaken to encourage
them to utilize the assessment tool and to increase awareness for
preventive/wellness initiatives.
 Enhanced focus on preventive services – TPA’s should be contractually required
to report on standard HEDIS data such as retinal eye exams for diabetics, ED
visits, etc. Furthermore, the University should fully explore the opportunity to
provide cardiac rehabilitation to the citizens of the Commonwealth. Not only will
this provide the University with greater information on TPA performance, but it
will demonstrate to the Commonwealth that improving health of it’s citizens
serves a greater need.
 Demand Management – Publicize and market the use of triage phone numbers
and explore the opportunity for a broad based educational effort on inappropriate
utilization by plan members. This should assist in decreasing inappropriate
utilization of the system.
 Health Improvement Programs – Include the Be H.I.P. program within health plan
operations. Allow participation in such programming on organizational time,
similar to an EEP offering, and encourage the physician community to utilize the
behavioral interventions through our marketing/detailing strategy. Effective
behavioral interventions can decrease utilization and contribute significantly to
better claims experience.
Integrated Assessment Tool
Enhanced focus on prevention
Demand Management
Health Improvement Program
Est. Cost