Using disease-state management as the key to promoting employer sponsorship of medical nutrition therapy

The purpose of this project was to design, implement, and improve a nationw ide medical nutrition therapy (MNT) intervention program for nutritionally at-risk employees and their dependents and retirees (hereinafter referred t o as clients) with a Fortune 100 company (Texas Instruments, Dallas, Tex) w ith a dispersed population of 80,000. Preferred Nutrition Therapists (PNT), a network of registered dietitians, with the assistance of the Texas Instr uments Health Promotion and Benefits Department, identified International C lassification of Diseases, 9th ed (ICD-9), codes for which MNT intervention was appropriate. PNT then negotiated a contract with the Texas Instruments Health Promotion and Benefits Department and implemented clients' self-ref erral process. The main challenge was to promote utilization of a new servi ce from an outside vendor (PNT) and to measure outcomes in meaningful ways. The goal was to use MNT as a tool to prevent the progression of clients' d iseases to states that require more costly treatments. PNT used a continuou s quality improvement process to refine the system and improve information gathering and reporting, by providing quarterly reports to the Health Promo tion and Benefits Department. These reports summarized the outcomes for all clients seen at least 3 times during the quarter. The cost was less than $ 0.35 per member per month (less than the employer spent on advertising the program), and 0.5% of the population requested MNT during the first year of implementation (about what was expected for a new carveout benefit).