by Robert Marcoux
Glucagon-like peptides-1 (GLP-1) medications are currently on the rise due to the popularity for managing weight control. Initially prescribed for the treatment of diabetes, an identified secondary benefit was as an appetite suppressant. This created a sudden increase in demand as individuals seek access to the variety of GLP-1 drugs to manage their weight. Consequently, benefit plans are evolving to now provide levels of coverage for these medications. While long-term results are still under study, the growing usage has created supply issues, contributing to costs exceeding $10,000 per year per patient. The question becomes can weight management be a combination of treatments resulting in lifestyle changes to enact forever effects to sustain an individual’s healthy weight.
Source: www.milliman.com/en/insight/payer-strategies-glp-1-medications-weight-loss
Hines & Associates, a 36-year URAC accredited medical management company believes not only can it be done but it is the most responsible means to deliver an effective program. Founded by a Registered Nurse, her mission was to assist patients along their healthcare journey. Hines curates and clinically supports a patient’s pathway to better health and wellness through traditional medical services of Utilization Review, Case Management, Disease Management, Physician Medical Case Review and Wellness. It operates in all fifty states with health coaches, nurses, and physicians to proactively engage with the patient aided by technology including Healthy Tomorrows.
Healthy Tomorrows, available as a web portal or smartphone app is a digital wellness assistant to educate, motivate, track, and manage an individual’s progress to better health. Augmented by certified Health Coaches, participants engaged to higher levels of accomplishment.
HINES CLINICAL GLP-1 WEIGHT MANAGEMENT WRAP PROGRAM
In Hines’ Clinical GLP-1 Weight Management Wrap Program, an individual requires completion of all three phases in order to be reimbursed for the member’s co-payments applied to the medications administered. The major elements to the program include:
- Healthy Tomorrows platform for health & wellness management, monitoring, and reporting. (See below)
- Hines’ Healthy Tomorrows Wellness smartphone app and web portal.
- Personal Health Coach.
- An educational review with insight into alternative and complementary treatments.
- Virtual office visits with a medical doctor (MD).
- GLP-1 prescribed medications based on a medical assessment by a MD.
- GLP-1 Pharmacy Benefit Management partner.
- Weekly monitoring.
Our program supports and can integrate with multiple configurations. Whether a health plan with a traditional carrier network, or as an overlay to an existing Utilization Review/Case Management program, or if the desire is to have a new stand-alone GLP-1 offering that delivers successful clinical and financial outcomes.
We believe that a program which integrates diet, nutrition, regular exercise aided with GLP-1 medications that are controlled and monitored by clinicians can lead to long-term gains with forever lifestyle changes. And we stand by this position to the degree we will guarantee results.
To learn more about Hines Clinical GLP-1 Weight Management Wrap Program please contact Robert Marcoux at email bmarcoux@hinesassoc.com or to schedule a virtual appointment please click here.
