Healthtrac Inc.

Narrative Description of Program

Healthtrac offers cost-effective need and demand reduction programs to managed care organizations (Blue Cross Blue Shield, Kaiser, Health Systems International, etc.) and employers throughout the US. Programs are sold internationally through franchise and partnership arrangements. The individual participant pays nothing.

The Basic program is designed for employees and their adult dependents. Additional program are Senior Healthtrac (for retirees) and Babytrac (for women who are pregnant or who are planning a pregnancy). We recently implemented a High Risk program for those with chronic conditions or lifestyle risk factors which portend potential high costs in the near term.

Health risk data is acquired through carefully-validated health assessment questionnaires, repeated at regular intervals. Computer files are serially-linked, enabling reinforcement of progress, recognition of change, and program evaluation. Individual feedback is provided in the form of personalized letters. Graphic reports display progress over time.

Deliverables include the self-care guide, Take Care of Yourself, proven-effective to reduce unnecessary medical care use and costs. Books, pamphlets, video tapes, and audio tapes are provided, as determined by individual needs.

This application presents newly-released results from extensive evaluation studies of both the Babytrac and the High Risk programs, published studies of the effectiveness and cost savings in the arthritis and Parkinson's Disease modules, and development of algorithms which identify high cost/risk individuals.

Narrative Description of Evaluation Results

With a strong academic foundation and a commitment to evaluation, Healthtrac programs have been extensively studied. They have been documented-effective in more peer-reviewed studies in major medical journals than other programs. An initial C. Everett Koop National Health Award winner, Healthtrac received this honor in 1992 and 1994. Since then, additional studies have been completed and these are highlighted in this submission.

Listed (Section III) are thirteen studies. Ten of these (articles 4-11) have been published in major medical journals. Three are in the publication process. These document both health risk and cost reduction for indemnity and managed care plan members. One of the largest randomized control trials ever conducted, the PERS study (5) was recently cited in Proof Positive (Chapman, L., 1996) as the best health education and cost savings study ever conducted.

The first five studies document the results of the most recent Programs, Babytrac (study 1), High Risk (studies 2 and 3), the Arthritis program (study 4), and the Parkinson's Disease program (study 5).

New results since the 1994 submission reveal the success of our:

• chronic disease modules [arthritis (4) and Parkinson's Disease (5)]
• Babytrac Program (1) (resulting in a 50% reduction in low birth weight infants; ROI = 10:1),
• high risk/cost predictive model (2), and,
• high risk program (3) (ROI of 8:1 for program completers)

• Healthtrac Inc.

The following assessment of program strengths and weaknesses has been abstracted from reviews by the Task Force on Program Selection of The Health Project. Where weaknesses are postulated, it must be taken into account that the review Task Force is very critical, that no programs are perfect, that the Award Winning programs have been selected from over 300 candidate programs and represent the very best, that the materials reviewed may have been incomplete, that suggested deficiencies may have resulted from incomplete understanding of the program by the reviewers or that any problems may have been corrected since the time of review.

Evaluation

Healthtrac Inc., another prior award winner, has broadened its low cost need and demand management programs to include Babytrac, that demonstrates a 50 percent reduction in low birth weight infants; Senior Healthtrac with an 8 to 1 return on investment; and a High Risk program. Data acquired through carefully validated health assessment questionnaires and serially-lined computer files permits predicting costs for 12-18 months based on personal risk factors. Individual feedback is provided through personalized letters and graphic progress reports.

Healthtrac is a three time winner of the C. Everett Koop National Health Awards. Repeat winners are only allowed to compete in alternate years, and a new submission must contain solid overall work and also substantial documentation of progress since the prior submission. Reviewers noted continued improvement of an award winning program, with addition of data on the high risk program in multiple chronic disease areas and the Babytrac Prenatal Program. Development of techniques to predict medical costs in the following year allowed channeling of subjects into appropriate interventions. Behavioral techniques are superb. Very complete and comprehensive. Excellent data collection and reporting. Very high level and sophisticated program. A program with reasonable approach at minimal cost per participant. Clearly identified health benefits demonstrating significant reduction in health risks and demand as well as cost-savings. Strong documentation of benefits and savings provided. The Health Assessment Program is validated. The channeling into the specific programs has merit. There are multiple peer-reviewed articles documenting both effectiveness and cost-savings.

Proposal does not clearly identify program goal, however, it is implied through program materials. Evaluation plan and results are not presented as well as they could be although there is a list of publications and abstracts. Several reviewers noted the continued evolution and expansion of the program vision rather than radically new approaches.