Company helps patients master life

From the early days of HMOs to her latest role as president and CEO of disease state management company Lifemasters Supported SelfCare, Christobel Selecky has seen changes galore in the healthcare sector. Those changes include redefining what Lifemasters does: "I would call it a health improvement company. We're focused not so much on disease but on people. People don't like to be called diseases." HME News: How does Lifemasters work? Christobel Selecky: Our contractual relationships are with payers, whether it's a health plan, government entity or self-funded employer-anybody who's got risk for the cost and quality of health care. They ask us to identify populations of their members or employees who have certain chronic conditions, using data analysis and claims. HME: Then what? Selecky: We stratify them into different levels of severity. There's a rule: 20% of the people drive 80% of the costs. We have different interventions based on different levels. (A patient) is assigned their own nurse, who calls them on a regular basis. They really help coach the person around being more adherent to the treatment plan. HME: So, in a sense, you're lifestyle coaches? Selecky: We help when they quit smoking, or lose weight. We (also) monitor biometric data like vital signs and symptoms. For example, for a diabetic, we have a Web site where they can enter their daily blood sugars and our system monitors those values. If somebody has an out-of-bounds event it triggers an off-schedule phone call from a nurse who will try to find out (what's going on). In about half the cases it's behavioral. HME: And if it's not behavorial? Selecky: We are very careful to make this program a reinforcement of the doctor-patient relationship. We don't want to say, "Your doctor gave you the wrong drug.' That's not our job. We will strongly encourage the person to go back to their doctor and talk about it. We will even give them some of the words they can use to talk to the doctor so they can have an efficient conversation. HME: Why should society be concerned about chronic illnesses? Selecky: I would say a major driver of the healthcare cost crisis in this country is the increasing incidence and prevalence of chronic diseases and the fact that our healthcare system wasn't set up to deal with chronic conditions. HME: Will we see more trends toward health management in the future? Selecky: We're trying to get CMS and Congress to understand how disease management and health improvement might play a role in helping us in our struggle with what we do with the Medicare trust fund that appears to be headed toward bankruptcy. The incidence of chronic disease is growing the most quickly in that population. Frankly, it's sucking the Medicare trust fund dry. If we don't do something differently, we are going to run out of money. HME