People with high cholesterol levels typically aren't ready to focus on the problem, and when they get a call from a case manager, they decline the program, he says. So an important aspect of the Sage plan is that members voluntarily sign up for it, and that means they are willing participants, he says.

Members are triaged into high-risk and low-risk groups. Health Net reaches out to members in the low risk group to encourage healthy behaviors, including appropriate use of statins. The high-risk group includes people who are experiencing significant problems such as angina, stroke, or heart attack. This group receives a comprehensive disease management program that includes counseling on co-morbid conditions as well as coronary artery disease.

Alere Medical Inc. provides the disease management services. Sage members show an increase in statin compliance from a baseline of 40% up to 55%, with an eventual goal of 70% compliance, Dr. Jacobs says.

Elaine Zablocki has been reporting on healthcare for more than a dozen years, and serves as a member of Health Net of Oregon's Member Advisory Council.