George K. Heuser, MD
VP & Senior Medical Director
Optima Health
November 8, 2011

• Improve Access to Basic Healthcare
• Chronic Disease Management
• Obesity Prevention

Overall Impact of Chronic Disease in the U.S.
• By 2030, there will be about 71 million adult baby boomers who will have reached their 65th birthday.
• At least 80% of older adults (age 65+) have at least one chronic disease; 50% have two.
• Chronic diseases claim the lives of 1.7 million
Americans each year— 70% of all deaths. Heart disease , stroke, cancer, COPD, and diabetes account for two-thirds of all deaths.

~ 40%
~ 30%
~20%
~10%
Behavior: tobacco use, nutrition,
Weight, MDD (movement deficit disorder)
Genetics
Environment/public health
Health Care Delivery
US Dpt of Health and Human Services, Public Health Service. Healthy People 2010: National Health Promotion
And Disease Prevention Objectives.

CVD and Non-preventable Risk Factors
• Age- 65 and older
• Minorities- Blacks, Native Americans
• Gender- Men in terms of most risk factors; women in terms of stroke and arthritis
• Persons with a family history of chronic disease
(genetics)
• Young children/adolescents- less physically active today and have higher rates of poor dietary intake; non-preventable because children do not often have control over their own physical activity or dietary intake- parents/other adults do!

~ 40%
~ 30%
~20%
~10%
Behavior: tobacco use, nutrition,
Weight, MDD (movement deficit disorder)
Genetics
Environment/public health
Health Care Delivery
US Dpt of Health and Human Services, Public Health Service. Healthy People 2010: National Health Promotion
And Disease Prevention Objectives.

CVD and Preventable Risk Factors
• Smoking/tobacco use
• Obesity- Body Mass Index (BMI) of 30 or greater
• Overweight- BMI of 25 – 29.9
• Poor diet- eating less than five fruits for vegetables per day
• Sedentary lifestyle- no leisure time physical activity within 30 days
• High blood pressure and high cholesterol independent risk factors/conditions associated with type-2 diabetes and heart disease
• And… lack of education on signs and symptoms of heart attack and stroke!!

Diabetes as an Independent Risk Factor for CVD
• Diabetes can lead to: coronary heart disease, stroke, peripheral artery disease, cardiomyopathy, and congestive heart failure.
• People with diabetes are two to four times more likely to have a heart attack or stroke than people without diabetes.
• People with diabetes are more likely to die from a second heart attack than people with CVD who do not suffer from diabetes.
• A secondary diagnosis of CVD is found in about
75% of all diabetes-coded deaths.
Source: http://www.ndep.nih.gov/control/CVD.htm.

Optima’s Integrated Clinical Care Services
• We manage every component ourselves
• Member-centric delivery of services
• Focused on employer group types
– Health & Prevention
– Pharmacy Management
– Medical Care Management
– Behavioral Health Management & EAP
– Disease Management
– Quality Improvement
• Population identification and stratification
• Predictive Modeling for future risk/service need
• Collaboration with Providers

Optima CAD & CHF Population Prevalence and Medication Possession Ratio

• Onsite health screenings
• Wellness topic speakers
• Exercise
• Cardiac health improvement
• Nutrition
• Stress management
• Tobacco cessation
• Healthy aging for seniors
15

• Blood Pressure
• Total Cholesterol, High Density Lipoprotein
• Body Mass Index (BMI)
• Information to reduce health risks
• Nurse counseling on results
• Nutrition counseling
• Offered monthly at Sentara Obici Hospital for the community 16

Healthy Heart
Improve your heart health
Get Off Your Butt: Stay Smokeless for
Life
Stop using tobacco and benefit your health
Eating for Life
Develop healthy eating and exercise habits
Yoga
Stretching and strengthening exercises
WalkAbout with Healthy Edge
Walk your way to better health
Sentara Living
Healthy aging for seniors
17

18