Heart Failure (HF) Program Overview

How the Program Works | Facts You Need to Know | Compliance Management | National Guidelines | HF Outcomes | High-Risk Program

How the Program Works

The Heart Failure (HF) Program helps individuals with chronic heart failure to understand their illness and the serious health effects from not complying with care plans. In order to prevent disease progression, disability and the development of other chronic conditions, we focus on treatment plans, medication compliance and modifying unhealthy lifestyle behaviors.

Our specialized nurses work with participants to recognize and control HF symptoms that lead to the worsening of their condition. This can include heart attacks, stroke, kidney failure and respiratory illnesses. Our program has repeatedly demonstrated that helping individuals be proactive in managing HF results in reduced medical expenditures, increased productivity in the workplace and improved quality of life.

We encourage our participants and work with them to:

• Comply with prescribed medications to reduce fluids, lower blood pressure and/or improve circulation
• Develop a healthier diet of low-fat, low-cholesterol foods
• Avoid salt
• Weigh daily and assess for acute weight gain
• Lose weight, if indicated
• Avoid caffeine
• Quit smoking
• Exercise
• Reduce stress
• Know when to seek medical treatment

Through educational materials, Web tools and telephonic interactions, we help people with HF learn how to quickly recognize the early warning signs of this disease. Alere provides guidance from our specialized nurses who help participants take better care of their heart failure symptoms, which allows them to better combat this disease.

This results in an improvement in quality of life and prevention of costly or unnecessary healthcare expenditures. By working with participants to alter their regular routines, we help them reduce disabling symptoms that result in absenteeism, presenteeism and a reduced quality of life.

Facts You Need to Know

Nearly 5 million Americans are living with heart failure, the nation’s leading cause of hospitalizations.1 Heart failure is the only major cardiovascular disease rising in both incidence and prevalence, with 4.8 million afflicted Americans and 400,000 to 700,000 new cases diagnosed each year.2

The estimated direct cost for heart failure is approximately $29.6 billion annually in the United States alone.3 Preventable risk factors for heart failure include obesity, smoking, diabetes, CAD, COPD, hypertension, high blood cholesterol and lack of exercise. But there is a long list of non-behavioral risk factors, including but not limited to, past heart attacks, abnormal heart valves, heart muscle disease, heart defects at birth and viral infections.

Compliance Management

Our program is designed to help participants comply with their doctor’s plan of care. This involves several key clinical performance indicators based on national standards.

While working with participants, we track their adherence to these standards and report back measurable results to show program impact on participant compliance. For participants with heart failure, we monitor the following:

Heart Failure-specific CPIs

• Use of ACE/ARBs
• Kidney function testing with use of ACE/ARBs
• Vasodilator use other than ACE/ARB
• Beta blocker use
• Digoxin use
• Kidney function testing with digoxin
• Diuretic use
• Kidney function testing with diuretic use
• Statin use
• Liver function testing with statin use
• Non-statin antilipemic use
• Adherence with restricted fluid diet
• Adherence with daily weights
• Aspirin use

Standard CPIs for all Care Solutions Programs

• Body mass index (BMI)
• Blood pressure
• Lipid management
• Physical activity
• Tobacco cessation
• Flu vaccination
• Pneumonia vaccination
• Preventive screenings (age and gender specific)

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 HF Program is based upon national guidelines from the:

• American Heart Association
• American College of Cardiology
• Institute for Clinical Systems Improvement

HF Outcomes

The HF Program produced the following results for a range of clients:

• Reduced hospitalizations by 29.5 percent and per member per month (PMPM) hospitalization costs by 14 percent
• Reduced emergency room visits by 27 percent and PMPM emergency room costs by 28 percent
• Reduced hospital days by 17 percent
• Reduced pharmaceutical PMPM costs by 9 percent
• Reduced total PMPM costs by 9.5 percent

High-Risk Program

The key difference between Alere's configurable solutions, designed to address all segments of a client's population, is the use of the Alere DayLink® Monitor. It is a biometric measurement device that records a participant’s weight and/or answers to pre-programmed questions regarding their symptoms. This information is gathered daily and sent to our clinicians for review.

Other differences include additional assessments, including a Quality of Life Survey at enrollment and six months after the onset of the program, and a Patient Satisfaction Survey after six months. Additionally, these participants receive more telephonic outreach and coaching calls.