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Health plan to launch initiative for small employers to encourage wellness, disease management programs

A health plan that covers hundreds of New Jersey small employers is planning to launch an initiative to encourage those employers to engage their workers in wellness and disease management programs, specifically ones that are successfully improving health and reducing unnecessary health care spending.

The Affiliated Physician & Employers Health Plan is a multiemployer health plan managed by Piscataway-based QualCare, a health care company. Since 2006, QualCare has offered wellness and disease management programs within its entire family of health plans, which serves approximately 180,000 members.

QualCare’s APEHP covers about 1,200 employers and their 22,000 workers and their families. Over the past few years, the APEHP has seen significant growth, much of it the result of a partnership with the Employers Association of New Jersey whose members are eligible to join the APEHP.

John Sarno, president of EANJ, said he wants to encourage more small employers to take advantage of QualCare’s wellness and disease management programs, which help individuals with chronic diseases — such as diabetes, heart failure and hypertension — to better manage their ailments.

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On Oct. 14, Sarno will convene an information session in Edison where Dr. Christopher Valerian, chief medical officer of QualCare, will explain the program to employers.

“This voluntary program is designed to ensure that covered employees remain healthy, productive and happy,” Sarno said. “Working with a nurse case manager, participating employees will receive information and advice on their healthcare needs, preventative care and lifestyle choices — all within a confidential relationship.”

Sarno said employers won’t have to pay extra fees to participate in the disease management program.

Sharon Seitzman, executive vice president of QualCare, said that since QualCare launched its wellness and disease management program in 2006, the company has seen a positive impact. Large employers are more likely to participate, and she said Sarno, who is a trustee of the APEHP, is hoping to encourage more smaller employers to participate.

Seitzman said QualCare has found that its program is getting results. QualCare monitors hospital admissions and emergency room visits, “and we see with those members enrolled in the disease management program, the trend is for (hospital) utilization to come down.”

QualCare is also seeing a trend toward better health outcomes for individuals with chronic diseases who are enrolled in the program, compared to those who are not participating, she said.

Improving the care of chronic disease will ultimately benefit the entire membership, Sarno said, since a major cost driver in health care are chronic diseases like heart failure, diabetes and asthma.
“If we can help employees manage their health care more efficiently, then long term that will benefit the entire group because people will use healthcare more efficiently,” Sarno said.

He said the program is “an investment in the long term sustainability of the health plan." Iin the short term, employers will benefit as better disease management fosters a healthier, more productive workforce, he said.


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