Accountability is an important element of our disease management program, both for employees as well as between Sky and our employer clients. When possible, we recommend the use of claims measurements systems which provide data to assist in measuring the effectiveness of our program. Accountability and measurement are two elements which make our disease management significantly different than a traditional wellness program.
As an example under one particular such claims system, each employee is designated with a risk index (RI) based upon their actual medical claims history, pharmacy history and overall condition, as well as their basic demographics such as gender and age. The RI is a base number to describe the risk of the average person with these same conditions and demographics.
The employee is also given an adjusted risk index (ARI) which takes into account their actual compliance with the evidence based medical norms for their particular conditions. The goal becomes to work with these members to have them become more and more compliant with the recommended evidence based medical norms, thus moving the ARI as close as possible to their basic RI.