“This is much more than I expected from a health insurance plan!”
That’s the sentiment expressed by John Costa, a New Bedford teacher who recently completed a Blue Cross-sponsored diabetes prevention program that gave him free access to a health coach, a support group and the resources of his local YMCA. It helped him lose weight and find a healthier lifestyle, significantly lowering his risk for type 2 diabetes.
Natalino Zamboni, an 82-year-old Springfield retiree, was similarly delighted when we offered him the services of Landmark Health, which provides home visits and health monitoring for some of our sickest Medicare Advantage members. For Zamboni, our partnership with Landmark Health has meant fewer stays in the hospital and greater peace of mind.
What Costa and Zamboni discovered is that we do not just offer health coverage: Much of our work centers around identifying people who are at risk for or already living with a serious illness or chronic condition, and collaborating with their doctors, employers, families and community resources to help them improve their health and wellbeing.
Preventing diabetes, one step at a time
In a unique partnership with YMCA Southcoast, Old Colony YMCA and the cities of New Bedford and Taunton, we provided financial support for the Centers for Disease Control-certified program that has helped Costa and dozens of his colleagues. The yearlong program was offered to city employees and covered spouses who live with elevated blood sugar levels and other factors that put them at increased risk for type 2 diabetes. Focused on helping participants make healthy lifestyle choices, the program includes a one-year YMCA adult membership and group meetings with a certified Y lifestyle coach, all at no cost to the participant.
The program’s two major goals are for participants to lose 7 percent of body weight and gradually increase physical activity to 150 minutes per week. Costa did even better, dropping 18 percent of his weight and significantly lowering his blood glucose level to a normal range. He credits his YMCA Southcoast lifestyle coach, Sy Yules, above right, and the camaraderie fostered in his group as keys to his success.
“We learned that it’s not just about eating better and exercising more – it has to be a real lifestyle change in order to last,” said Costa, above left. “As a math teacher, what clicked for me was attaching a number to my choices: 3,500 calories equals a pound of fat, so if you cut 500 calories a day from your normal diet, you can lose about a pound a week.” He regularly used the YMCA’s treadmills and fitness classes to increase his exercise levels, and his group meetings offered ongoing support and accountability. “We kept journals of everything we ate. Our saying was, ‘If you bite it, you write it!’”
Participants are taught about lifestyle modification, not dieting, emphasized Dara Midwood, coordinator of the diabetes prevention program at YMCA Southcoast, above center, adding that she was constantly impressed by the energy, good humor and determination of Costa’s group of 12. “There are always barriers to making the healthier choice in eating or activity, but they are better prepared on how to get around, through or over those barriers and continue being successful.”
New Bedford’s human resources director, Sandra Vezina, noted multiple benefits from our collaboration, both for the city and its employees: “It enhances our current wellness programs,” she said. “It provides employees with a proven method to improve their health and wellbeing, at no cost. It helps them become happier and more productive employees. And it potentially helps us avoid high claim costs in the future.”
Offering house calls for our sickest members
Across the state, in Springfield, Natalino Zamboni, the good-natured patriarch of a large and devoted family, has been struggling with end-stage chronic obstructive pulmonary disease and other chronic conditions for years. Often, when he had trouble breathing, family members would bring him to the hospital emergency room for help, and as his COPD worsened, he was admitted to the hospital with greater frequency – up to four or five times a year.
Last year, our company’s care management team determined that Zamboni was eligible for a new house-call service that we offer at no extra cost to Medicare Advantage members who are living with five or more chronic conditions. When members like Zamboni (or their health care proxy) choose to participate, clinicians from Landmark Health-affiliated medical groups – physicians, nurse practitioners and physician assistants – are available for home visits any time of the day or night as medically necessary.
Landmark’s clinicians collaborate closely with our members’ personal physicians to support patients with highly complex medical needs. The process begins with a home visit to assess health and discuss treatments, medications and health goals. As Zamboni puts it, “Landmark Health just popped up. They called and said they were working with my Blue Cross Medicare insurance. They asked if they could come visit me in my home. I said, ‘Sure.’ Now, my Landmark doctor comes to see me every two to three weeks. She said, ‘Just call me anytime you need me; don’t worry about it.’”
Zamboni also sees his personal physician every three months and his physician is updated after each home visit by a Landmark clinician. With this enhanced combination of services, Zamboni has achieved significant improvements in his health and quality of life. He has been weaned off oxygen and he has stayed out of the hospital for more than a half-year. This means he can focus much more on what really matters to him – his love for his family.