Wednesday, May 28, 2008

Norwegians, Depression and Lifemasters' New Depression Program

Yes, that is a disturbing painting, isn’t it? 'Madonna' is by the Disease Management Care Blog’s fellow Norseman Edvard Munch, who is probably best known for his infamous 'The Scream' (or ‘Skrik,’ better translated as Shriek). Based on these and his other artworks, the DMCB suspects Edvard was not a very happy person. In fact, art historians have pointed to his family history, traumatic childhood, likely alcoholism and recurrent depression as major forces that shaped his artistic genius.

And why not? Edvard was born in Norway, which is rainy, cold and dark for half of the year. In addition to the weather, turn of the century Scandinavian culture is not known for its party animals. Or, maybe there’s something in the water or the genes. So it was with some interest that the DMCB noted LifeMasters’ latest entry into a population that may include some of Edvard’s descendants. We’re talking about Minnesota, the land made famous by widespread disdain for Christopher Columbus, deserved admiration for the stoic Norwegians that inspired Garrison Keillor’s Lake Wobegon and the inexplicable persistence people who still eat lutefisk.

But seriously, suicide rates in Norway are lower compared to other parts of the world and Minnesota’s depression rates are not comparatively high either. The DMCB interprets this to mean that programs that improve the detection and treatment of depression are needed as much in Minnesota as anywhere else. That’s especially true considering how ‘usual medical care’ performs in this area and the considerable literature that supports the use of disease management.

According to the press release, the disease management company LifeMasters has used some newly infused money to build a depression program. One buyer is Preferred One Health Plan in Minnesota. Along with other managed care organizations, Preferred One has case managers that are tasked to depression care in its network. Lifemasters provides the telephonic care.

Interested in learning more, the DMCB contacted Lifemasters. They will also perform claims analyses and predictive modeling to identify Preferred One enrollees at greatest risk. Accordingly, patients will be recruited into the program; patients may also self refer and physicians can also. Depending on clinical need and severity, patients may be followed by the case managers or the Lifemasters nurses. There will also be hand offs, depending on how well the patients are doing. This program is in its earliest phases, just having gone through a pilot phase. There’s no information on Lifemasters’ web site, but ‘more information will be made available in the future.’ As for peer review publications so the DMCB can help its readers assess the impact on outcomes, ‘not yet.’

The DMCB recalls that physicians may chafe over the prospect of their patients being ‘cold’ contacted over a possible condition of depression using claims, pharmacy or other relatively inexact data. Some patients are undoubtedly destined to be upset also. However, depression is prevalent, burdensome, costly as well as treatable. Disease management has a track record of success. 'Nuff said.

Lastly, this is another example of an emerging pattern of collaborative integration of program components that blur the distinction between carve outs, carve ins, managed care, provider networks and disease management.

The DMCB wishes Preferred One and Lifemasters good luck on this. Hopefully we’ll hear more on how this initiative is progressing and how Edvard’s relatives and the rest of the clan are doing.

May 31: In the original post, the title ascribed the new program to Healthways. It's obviously Lifemasters. The DMCB regrets the error.

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