It’s no secret that impactful population health initiatives can be difficult to implement. They need active participation from payers, providers, patients, caregivers, pharmacies and a range of other stakeholders to generate compelling evidence that demonstrates the value of bringing an initiative to scale. This support may include high-quality, longitudinal data and an understanding of real-world clinical engagement that can be sufficiently trusted by all parties to tell a comprehensive story about patient care.
Over the past several years, Optum Life Sciences has worked with leading life sciences companies to break down these barriers and pilot a range of innovative population health programs. These programs aim to address challenges like disease prevention, early diagnosis, appropriate treatment selection and ongoing disease management.
Recently, we worked with Amgen, a biopharmaceutical company dedicated to improving patient outcomes within cardiovascular disease, to pilot a program targeting a perennial population health challenge: lowering cardiovascular disease risk for patients with hyperlipidemia (high cholesterol).
About 38% of U.S. adults have hyperlipidemia, a key risk factor for cardiovascular disease, which is the leading cause of death in the U.S.1 Cardiovascular disease costs the U.S. about $219 billion each year, which includes the cost of health care services, medications and premature death.2 Only 55% of U.S. adults who could benefit from cholesterol-lowering medication currently take these drugs, leaving many patients at risk.3
“Our work with Optum Life Sciences reflects our shared commitment to build programs that help draw from evidence-based treatments and solutions to best serve patients,” says Bethany Kalich, PharmD, the U.S. medical director for Amgen’s cardiovascular disease portfolio. “We are always looking for new ways to collaborate within the industry and innovate for better care outcomes.”
Managing hyperlipidemia to improve patient outcomes
Despite clinical guideline recommendations, lipid-lowering therapy (LLT) utilization remains low. There are many reasons for this, but among them are gaps in the care continuum. These include the coordination and follow-up needed to address high lipid levels once they are identified.
To address one of these challenges, Optum Life Sciences and Amgen designed a program to improve awareness of adherence to the American College of Cardiology (ACC) and American Heart Association (AHA) hyperlipidemia clinical guidelines for patients with hyperlipidemia. The initiative involved both primary care provider outreach and increased patient awareness. The program highlighted opportunities for guideline-based care to help providers prioritize provider and patient discussions for treatment and management options.
Statins remain the first line of treatment to lower low-density lipoprotein (LDL). However, some patients may benefit from additional therapies or may require additional labs for ongoing management. The framework for managing patients can quickly become complex.
“Amgen took a collaborative approach to the program. They wanted to do something new in the space with providers instead of a lunch-and-learn or medication adherence program,” says Tina Kelley, senior director at Optum Life Sciences. “Optum then identified health plan leaders and providers who wanted to tackle the same problem with their patient population.”
Leveraging the provider and patient relationship
Optum Life Sciences designed a pilot program leveraging our consultants’ extensive experience working across all parts of the health care ecosystem, our ability to convene different stakeholders from across the enterprise, and our robust real-world data. Supporting information was gathered from January 1, 2020, through May 31, 2022, and included approximately 4,000 patients.
The program was integrated into current health plan communications processes with members and providers. It was comprised of 2 parts:
- Patient mailer: Members received a personalized mailer to encourage a discussion with their provider regarding their potentially high LDL-C at their next appointment. A data-driven assessment of guidelines-based care determined the patients who would benefit from such a discussion.
- Provider information packet: Providers received information about their patients with hyperlipidemia. This included an assessment of their patient panel aligned with guideline-based care. It was accompanied by specific lists of patients, with recommendations for action and a copy of the patient mailer.
“The program builds on the trusted relationship between a primary care provider and the patient by equipping both of them with information to discuss treatment guidelines for high cholesterol,” says Dr. Brian Solow, chief medical officer of Optum Life Sciences. “Working together, we can identify opportunities to unlock value for the health care system, for society and for patients we couldn’t unlock alone.”
Discovering insights to inform future strategies
Optum Life Sciences experts evaluated the program’s impact through an analysis of its proprietary claims and electronic health record (EHR) data assets. Significant findings included:
- 22% increase in patients treated according to guidelines in the secondary prevention patient group (patients with at least one cardiovascular event, such as a stroke or heart attack)
- 18% reduction in patients receiving no LLT
- About 50% of targeted patients had a care visit after receiving the mailer
- 10x increase in patients with LDL labs on record
Based on these insights and findings, Optum Life Sciences and Amgen have entered into a subsequent collaborative effort to engage more health plan members and enhance their provider experience. This initiative will begin in 2023 and continues to focus on guideline-based care.
“Collaborating across the health care system in diverse ways, including through analytics to improve patient access and personalized disease management programs, can positively impact the patient care pathway,” Solow says. “Our clients turn to us to execute pilots like the hyperlipidemia program to discover what strategies we can move forward at scale to improve patient outcomes.”
Learn more about how Optum Life Sciences can help design, pilot and scale patient and physician engagement programs.