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TRANSCRIPT
A New Paradigm in Diabetic
Care:“E3” Engage-Educate-Enhance
An innovative, physician coordinated care solution to the cost and
care management of Diabetes in the USA.
Developed by Jose Luis Chavez M.D. Founder, President and Medical Director
for Pulse Health Solutions
Bob McCollinsDirector of Sales and Marketing
Phone: 614-264-9694Email: [email protected]
▶ Diabetes is a growing workforce issue with serious health, productivity and cost consequences:
◦ 29.1 Million people have diabetes. That’s about 1:11◦ An estimated 79 Million people are prediabetic making them at greater
risk for developing type 2 diabetes, heart disease and stroke. 9 out of 10 do not know they are prediabetic.
◦ People with diagnosed diabetes incur on average 2.3 times the medical expenses of comparable people without diabetes. The largest of these expenditures is for treatment of complications.
◦ Employees with diabetes average two or more work days absent per year more than employees who don’t have diabetes.
◦ Medical cost, lost work and wages for people with diabetes costs $245B/Year.
◦ Risk of death for adults with diabetes is 50% higher than adults without.◦ It is estimated as many as 1:5 adults could have type 2 diabetes by
2025.
The need for “E3” Diabetic Care for “LIFE!”
ENHANCE: Physician
Coordinated Telehealth
EDUCATE: Coaching, Nutrition, Exercise
ENGAGE:
Diabetic Supply Savings
&Compliance Reporting
“E3” Engage – Educate – Enhance
“E3” Diabetic Care for “LIFE!”▶ ENGAGE…through directed savings.
o Quantified savings (15%-40%) on diabetic supplies through one of the top diabetic supply distribution companies in the United States based in Ohio.
o Includes important prescription refill monitoring and participant compliance reporting.
o Incentives for participation helps remove the cost barrier and drives patient participation and compliance.
▶ EDUCATE…better living and learning pathways. o Health coaching by Registered Dieticians (RD’s) and Certified Diabetic Educators
(CDE’s).o Medication Therapy Management to help participants get the best benefits from
their medications by actively managing drug therapy and by identifying, preventing and resolving medication related problems.
o Participants will have access to GemCareWellness.com, a health and wellness website that engages its members through personal health trackers, educational video’s, healthy learning quizzes and health management biomarkers and assessments.
▶ ENHANCE…physician managed utilizing technology for improved outcomes.o Physician coordinated care following medical protocols for treatment.o Communication with patient physician/care team.o Medical care delivered to your convenience and maximum outcomes.
▶ Engage – Diabetic Mail Order Supply Savings Program.◦ Immediate cost savings on diabetic supplies from15% - 40%.◦ Accreditation Commission of Health Care Inc. (ACHC) Certified.◦ Convenience - participants are shipped up to a 90 day supply to their
residence.◦ Participants are contacted 14 days before next shipment to verify the
order and determine if they are testing to the level the physician has recommended.
◦ Refill reminder program via phone, mail, email or text.◦ Order will arrive within next 2-3 business days after order has been
placed.◦ Next day shipments available at a participant charge of $20 for rush
orders.◦ All phone calls are answered “in person” by a professionally trained
customer service representative.◦ Participants receive a complimentary quarterly newsletter with helpful
hints on managing diabetes, recipes and other care facts.
“E3” Diabetic Care for “LIFE!”
▶ Educate – “The Diabetes Care Path.”The role of the health coach (RD, CDE, RN):
Set up initial appointments and quarterly outbound follow up appointments with participants.
Unlimited “inbound” calls to health coaches from participants are encouraged.
Monitor and educate participants on the need to test per physicians orders.
Educate participant on disease and prevention of short and long term complications.
Motivate participants to live a healthier lifestyle. Teach effects of carbohydrates, proteins and fat in the diet. Discuss physical activity habits, set goals and monitor progress. Document participant progress notes and lab values. Refer to medication therapy management program as needed.
“E3” Diabetic Care for “LIFE!”
▶ Educate – “The Diabetes Care Path.”The role of the pharmacist:
Manage participant drug therapy while educating them on use, frequency, side effects and precautions.
Advise on how to get the most out of the medications the participant is taking.
Assess adherence and tolerability with drug regimen. Answer participants medication, over the counter drugs, vitamins,
minerals and supplement related questions (cost, drug interactions, etc.)
Provide verbal education and training designed to enhance participant understanding and appropriate use of medications.
Collaborate with participants physician care team. Document participant progress notes. Set up follow up medication therapy management calls as needed.
“E3” Diabetic Care for “LIFE!”
▶ Enhance – “The Diabetes Care Path.” The role of medical care coordination and technology:
◦ Utilizing the technology of telemedicine to deliver convenience of in-home care monitoring by medical professionals.
◦ Daily voice or video calls to assess the general well-being of participant and proactively uncover any needs or concerns.
◦ Provide reminders of upcoming appointments, medication changes, etc.◦ No fuss vital signs monitoring using the weight scale, blood pressure cuff
or glucometer which is automatically sent wirelessly to your secure medical record.
◦ Emergency response and GPS is included and can help responders and caregivers find you when you can’t access 911 assistance.
◦ Personal care assistance to help you schedule a physician visit, nurse, physical therapist, or home health aide. Medical concierge services to help coordinate needed equipment, meals delivered to your home or other tasks around the house to make your surroundings safe and more mobile.
“E3” Diabetic Care for “LIFE!”
Diabetic Supplies Savings “Estimates”Good - $105 per diabetic testing participant annualized.Better - $140 per diabetic testing participant annualized.Best - $245 per diabetic testing participant annualized.*Actual savings analysis can be completed with Rx data request provided by TPA, Pharmacy Benefit Manager or Insurance Company.
▶ Engage and Educate Diabetic Care Path Carve Out Program Costs –
◦ $78.00 annual participant cost billed at $6.50 per participant per month.**Enhance Diabetic Care Path Program is only available after medical review recommendation and coordination with participants physician.
▶ Estimates of program savings and costs:◦ “BETTER” supply savings annualized @ $140 x #/participants = SAVINGS◦ Diabetic Care Path Program annual costs @ $78 x #/participants = Cost◦ TOTAL PROJECTED NET SAVINGS =
“E3” Diabetic Care for “LIFE!”
Diabetic Supplies Savings “Estimates”o Good - $105 per diabetic testing participant annualized.o Better - $140 per diabetic testing participant annualized.o Best - $245 per diabetic testing participant annualized.*Actual savings analysis can be completed with Rx data request provided by TPA, Pharmacy Benefit Manager or Insurance Company.
▶ Estimates of program savings:o Good - $105 x # of participants = SAVINGSo Better - $140 x # of participants = SAVINGSo Best - $245 X # of participants = SAVINGS
Engage and Educate Diabetic Care Path Carve Out Program:o Costs based on level of services provided per participant per month (pppm).
Estimated monthly costs range from $6.50 - $8.00 pppm.
“E3” Diabetic Care for “LIFE!”
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About Pulse Health Solutions
At Pulse Health Solutions we work to maximize the human performance of your workforce by addressing the issues of worker health, risk, safety, engagement and productivity.
We do this using both a consultative and clinical approach that will improve your workforce overall health and well-being.
As a result, our customers benefit by having a healthier, happier and more productive workforce that will impact their bottom line by reducing the cost and risks related to workers compensation, health insurance and absenteeism, all of which will result in increasing your profitability.
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About Pulse Health Solutions
We will serve as your “in-sourced” wellness department and provide the needed resources to assist or lead in developing a comprehensive year round program that supports your organizations culture of health, safety and risk management.
We will seek out the best wellness vendor to fit your unique needs related to improving the health, productivity and overall well-being of your workforce.
We are the only independent health and wellness consultant on the Ohio BWC Workplace Wellness Grant approved vendor list.
We will hold all parties accountable to administer your program as designed and that your program is 100% compliant with all rules and regulations for wellness plans.
Pulse Health Solutions services to help and provide advice are at no charge. Should you decide to implement a program with Pulse Health Solutions and one or more of our vendor partners, we are paid by the vendor. There are no surprises and you know our time invested in your organization is because we want to help.
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Established in 1992
Privately Owned
Financially Stable
Headquartered in Hudson, Ohio add’l locations in KY; NC; SC; MI
120+ Employees
80,000 Square Foot Facility
12,000+ Orders/Month
EHCS currently contracts with around 300 insurance carriers, TPA’s and other health plans
Edwards Health Care Services Company Profile (EHCS)
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EHCS is one of the top 10 Diabetic Suppliers in the USA (direct to patient).
EHCS is one of the top 3
largest Insulin pump suppliers in the USA.
EHCS is one of 21 Medicare
National Mail-Order Suppliers for diabetes test supplies.
EHCS currently supplies
over 18,000 active diabetics directly to their homes.
DBA’s: Diabetes Care & Education (DC&E), Direct Healthcare Supply (DHS)
Acquired the Assets of Diabetes Care & Education, November 2009
Acquired the Assets of EZ Diabetic Supplies, April 2014
National Specialty Provider of Diabetes Medical Devices & Supplies
Medicare, Medicaid, Commercial Payers
Ongoing Total Quality Management Program – Focused on People, Product, and Processes
Insurance Partnerships include:
◦ Medicare and Medicaid, Managed Care Plans and Exchanges, Regional and National PPO Networks for Self-Insured and Insured Plans
Accreditation Commission of Health Care (ACHC) Inc. Certified for ALL of our locations
Who We Are - EHCS
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Meters & Strips◦ Abbott◦ Agamatrix◦ Arkray◦ Bayer◦ BioSense◦ OakTree/EasyMax◦ HDI (Nipro)◦ Lifescan◦ Pharma Supply◦ Prodigy◦ Roche◦ Sanvita ◦ Simple Diagnostics
DME Supplies◦ Drive◦ Roscoe
Ostomy◦ Coloplast◦ Convatec◦ Hollister
Key SuppliersPumps & Pump Supplies
o Animaso Dexcomo Insuleto Medtronico Rocheo Tandem
Lancets, Lancing Devices, Syringes Sharps Container / Glucose Tabso BDo Covidieno Easy Toucho Niproo Owen Mumford
Incontinenceo Covidien
Wound Careo Covidieno Hollistero Smith & Nephew
o Pharma Supplyo Simple Diagnosticso Specialty Medicalo Sterilanceo UltiMed
Urologicalso Bard o Coloplast
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A New Paradigm in Diabetic
Care:“E3” Engage-Educate-Enhance
An innovative, physician coordinated care solution to the cost and
care management of Diabetes in the USA.
Developed by Jose Luis Chavez M.D. Founder, President and Medical Director
for Pulse Health Solutions
Bob McCollinsDirector of Sales and Marketing
Phone: 614-264-9694Email: [email protected]