Depression Program Overview

How the Program Works | Facts You Need to Know | Compliance Management | National Guidelines | Depression Outcomes

How the Program Works

Alere's Depression Management Program provides health coaches who seek to reinforce an employee’s capacity for self-reliance and self-determination through education, affirmation, information, advocacy, collaborative planning and problem-solving. Our goal is to enhance a client’s capacity and opportunity to change and address his or her own needs.

Our program links behavioral health and disease management programs with weekly case conference meetings including the patient, a mental health counselor and a registered nurse from the disease management program. As a result, employees are more likely to choose the most effective intervention options for their individual needs, facilitating a swifter recovery than they would experience in a standard mental health plan without the clinical expertise.

Health coaches also work with employees to develop individualized self-care plans and educate them about aspects of depression and various treatment options available. Through educational materials and telephonic interactions, we help employees:

• Identify all behavior health issues
• Understand the nature of depression
• Determine if they have depression and need to seek treatment
• Determine possible solutions and set goals
• Motivate patients to want to get better
• Learn to adopt self-care behaviors that mitigate or eliminate symptoms of depression
• Increase their tolerance to negative events
• Improve their overall health and ability to manage chronic illnesses if present
• Maximize productivity at home and at work
• Coordinate care with all involved mental health and physical healthcare providers

Facts You Need to Know

Depression can attack unexpectedly and consume your employee’s ability to work and function productively. To make matters worse, employees seeking help for depression can become overwhelmed by a complicated mental healthcare system and the challenge of making informed decisions about medications and treatment options. As a result, depression often is improperly managed.

Major depression is the leading cause of disability in the United States and affects approximately 19 million American adults. An estimated 5.8 percent of men and 9.5 percent of women will experience a depressive episode in any given year.

People suffering from chronic or catastrophic health issues are 60 percent more likely to be depressed and cost up to 40 percent more in healthcare costs. Depression frequently co-occurs with a variety of other physical illnesses, including heart disease, stroke, cancer and diabetes, and can also increase the risk for subsequent physical illness, disability and premature death, according to the National Institute of Mental Health.

According to the Disease Management Association of America, 70 percent of all healthcare visits are driven by a behavioral factor. A 1998 survey revealed that healthcare spending more than doubles for people with chronic illnesses and that more than half of healthcare spending is on behalf of people with multiple chronic conditions. Depression co-occurs with chronic conditions at alarming rates:

• 30 percent of cancer patients
• 27 percent of patients with diabetes
• 70 percent of patients with diabetic complications
• 18 to 20 percent of patients suffering from cardiovascular disease
• 40 to 65 percent of patients suffering from heart attacks
• 10 to 27 percent of patients suffering from stroke
• 45 to 70 percent of patients with multiple sclerosis, rheumatoid arthritis, cystic fibrosis, sickle cell anemia, Parkinson's disease and hemophilia
• 10 to 15 percent of all new mothers get postpartum depression

The bottom line, untreated depression is costly. A RAND Corporation study found that patients with depressive symptoms spend more days in bed than those with diabetes, arthritis, back problems, lung problems or gastrointestinal disorders. A study by the Journal of Psychiatry reported that left untreated, depression is as costly as heart disease or AIDS to the U.S. economy, costing over $43.7 billion in absenteeism from work (over 200 million days lost from work each year), lost productivity and direct treatment costs. Health-related loss of productive time in the depressed workers averaged 5.6 hours per week, compared with 1.5 hours per week in non-depressed workers.

Depression is not a passing mood. It is not a personal weakness. It is a major—but treatable—illness. No job category or professional level is immune, and even a formerly outstanding employee can be affected. There is treatment and hope for those who suffer from depression.

Compliance Management

Alere's Depression Management Program uses clinically-accepted tools and educational materials from the National Institute of Mental Health (NIMH) to help employees adhere to nationally recognized best practices by the Institute for Clinical Systems Improvement (ICSI).

We measure the patient's level of functioning and distress, which helps the health coach to determine if interventions are working. If not, the health coach alters the treatment plan accordingly. We measure individual clients as well as populations as a whole to generate improvements in productivity and functioning.

In addition, we track each patient's progress and generate an expectation of that patient's likely course of change according to the patient's self-reported baseline scores. Health coaches and employees rely on ongoing, interactive feedback and scores to guide the work they do together and determine if the coaching is effective.

In order to demonstrate the effectiveness of our program, we measure and report on the following performance indicators:

• Outreach and enrollment rates
• Medication compliance
• Emotional health improvement scores
• Utilization of healthcare services
• Productivity improvement scores for absenteeism, presenteeism and activity impairment
• Coaching relationship effectiveness scores

National Guidelines

We utilize nationally-recognized clinical guidelines, along with the latest clinical research and advancements in care, for each condition to drive our interventions. Alere’s Scientific Advisory Board, composed of our industry experts, guides and directs appropriate protocols for all programs.

The depression program is based upon samples of national guidelines from:

• American Psychiatric Association
• Institute for Clinical Systems Improvement

Depression Outcomes

Alere's Depression Management Program produced the following results for a range of clients:

Cost Savings:

• Reduced hospitalizations by 23 percent and per member per month (PMPM) costs by 15.25 percent
• Reduced emergency room visits by 11 percent and PMPM emergency room costs by 7.25 percent
• Reduced medical PMPM costs by 9.5 percent
• Reduced pharmaceutical PMPM costs by 7.25 percent
• Reduced total PMPM costs by 15 percent

Clinical Performance Indicators:

• 89 percent of patients expressed satisfaction with the program
• 65 percent of patients said they improved previously unsuccessful relationships as a result of the program