N.C. Program Reduces Health Care Costs

The Washington Post today profiles a disease management program in Asheville, N.C., that links city workers with pharmacists to control chronic illnesses and to reduce health care costs. Under the program, called the Asheville Project, the city pays pharmacists to counsel patients with diabetes, hypertension, asthma or high cholesterol on diet, exercise and medications. Patients in the program meet once per month with their pharmacist, who serves as a "bridge to physicians" and helps patients "stay on track," the Post reports. The program covers the cost of medication and medical supplies, such as glucose meters and test strips for diabetes patients, to encourage participation. The program has saved the city thousands of dollars and improved the health of city employees, the Post reports. Although pharmacists receive $40 per month per patient that they advise, the program has reduced costs for the city by "drastically reducing" emergency room use and complications that result from medication errors. "I can afford a lot more medications and physician visits than I can trips to the emergency room," John Miall, a risk manager for the city, said. In addition, worker sick days have dropped from an average of 12.6 days per year to six per year as a result of the program, the Post reports.

Some analysts said that "it will be difficult" for larger cities or companies to adopt a similar program, which would require a shift in funds and responsibility to pharmacists. The Post reports that physicians fear a loss of business or authority and have "expressed skepticism" about increased responsibility for pharmacists. In addition, health insurers have "shown little willingness" to reimburse pharmacists or other "non-physician" providers for counseling services. Disease management programs also may not control health care costs on a large scale. "We're doing what we can to control costs, but we're scratching at the margins," Bill Schaefer, the finance director in Asheville, said (Connolly, Washington Post, 8/20).