PLAN TO CARE FOR DIABETES IS EXPANDED BY H.E. BUTT

CAROL ANGRISANI

SAN ANTONIO -- After a successful one-year pilot involving a select group of hospital patients, H.E. Butt Grocery here is expanding a diabetes case management program to its employees and the general public. "There's high interest in this program. It's evident that this is a positive project," said R.C. Perez, program director. "Not only does it reduce health care costs, it improves the quality of life for these patients."

H-E-B also may launch more mobile case management facilities. It currently has only one in use, but has budgeted 12 for the year.

"We don't know exactly how many more mobile units will be added yet. It will be based on demand," Perez said.

The pilot program, slated to conclude within the next few months, has been offered to a select group of 178 patients from Nueces County's Medical Center. The hospital has reimbursed H-E-B $225 for each patient. Designed by E2M Health Services, Dallas, the program is expected to save about $350,000 in health care costs. Initial results show a 40% drop in clinic visits and a 30% reduction in trips to the emergency room.

Also, H-E-B pharmacists diagnosed seven patients with microaleuminurea, a precursor of renal disease. Because patients were diagnosed early and put on medication, they may not have to go on dialysis in the future, said Ed Barnwell, chief executive officer of E2M.

"This was not detected under their normal health care plan," Barnwell said. Services are offered inside a mobile unit located adjacent to

an H-E-B Corpus Christi store. The facility has a classroom, lab room, bathroom, reception area and two case management rooms. It is staffed by two technicians and four registered pharmacists, two of whom are diabetes educators. The program was officially opened to H-E-B employees last month.

A second group of patients from the medical center also may be enrolled.

Twenty-five H-E-B employees presently have signed up, though Perez anticipates 400 to 800 joining over the next year. Employees are charged $585, the majority of which is expected to be covered by their insurance plan.

The fee covers several different lab tests, including hemoglobin, cholesterol, blood pressure and blood glucose. Weight, height and temperature are also recorded.

After an initial assessment, patients get nutrition counseling and are told how their diet and exercise should be modified. "This is not just an education program, it's a case management program," Perez said. "Patients are taught how to control the disease."

Depending on how well the diabetes program is received, H-E-B may begin case management for other disease states, such as asthma and hypertension.