By Meghan Oliver

Sentinel Staff Writer

Governor Robert L. Ehrlich, Jr., helped launch Medicare's Health Support Program Monday at the offices of American Healthways in Columbia – a pilot program that will provide Medicare beneficiaries with direct access to nurses via a call center, as well as regular updates on disease-related information.

The three-year voluntary program targets patients with the chronic diseases of diabetes and congestive heart failure, providing them with information necessary to maintain their health and avoid or reduce hospital stays and trips to the emergency room, at no cost to them. Diabetes and congestive heart failure comprise 43 percent of all Medicare spending, explained Nancy O'Connor, regional administrator for the Centers for Medicare and Medicaid Services (CMS.)

CMS has divided the program into two phases, with Phase I being the initial three-year pilot, and Phase II being an expansion of the program based on evaluations of the first phase. Organizations like American Healthways throughout the country will implement the Health Support Program, and will be paid fees per person, per month. Fees will be refunded if the organizations do not meet the standards set by CMS for beneficiary satisfaction and improvement in clinical quality.

The Health Support Program is part of Medicare's recent makeover stemming from the Medicare Modernization Act President Bush signed into law in 2003. Medicare's focus today, O'Connor said, is "quality" and the "outcome of patient care."

American Healthways, a provider of disease management and care enhancement programs with headquarters in Nashville, Tenn., was chosen to implement the Health Support Program for Maryland and D.C., said O'Connor, for it's "proven track record of managing people's health" and for its "dedicated team of nurses."

Approximately 20,000 area beneficiaries will participate in the program, with CMS tracking the Medicare costs and overall health care experience of 10,000 of those selected to represent the control group.

The nurses of American Healthways, available by phone 24 hours a day, are to regularly call beneficiaries to remind them of medical tests and check-ups they need, suggest ways to reduce pain and answer questions about medication, hospital stays and nursing care. In addition, they are trained to screen for depression and provide end-of-life counseling.

"The nurses will get to know the beneficiaries they are working with," O'Connor said, who talked of the importance of a "human connection" between the medical field and patients.

Ehrlich was on hand to make the first phone call of the Health Support Program to beneficiary Dorothy Eaton of Queenstown to inform her of the benefits of the program.

"The goal here is to improve health care outcomes," the governor told Eaton. "In Congress there was the thought that Medicare could not be reformed, but this is going to make you healthier and keep you out of the hospital, and obviously (that is) better for the taxpayers as well."

Ehrlich, who joked with Eaton inviting himself to lunch at her home, called the program "a policy experiment that is well-rounded."

Eaton responded by saying such a program was vital to people like her who "don't have the funds" to get the medical treatment they need.

Registered nurse Marie Hancock, now a nurse trainer for American Healthways, said her 71-year-old mother had suffered from poor blood sugar control, hypertension and osteoarthritis, but made a complete turnaround after enrolling in the Health Support Program.

"Success does require human connection," Hancock said. Phone calls from nurses provide this connection, she explained, offering her mother as proof. There was a time when trips to the emergency room and dangerous blood sugar levels were the norm, but in the past two years, her mother has made a "remarkable recovery."

Photo by Marketa Ebert