In the last few years, one of the biggest challenges healthcare has faced on the road to value-based care has been chronic care management. The healthcare organizations we have today are well-equipped to treat acute episodes or countering emergencies, but there has to be a greater focus on managing chronic conditions and comorbidities. A report by the Centers for Disease Control and Prevention(1) shows the glaring statistics:
The fact that chronic conditions never exist in isolation and the threats relating to comorbidities only increase with age, it’s paramount that the focus shifts from treating acute episodes to manage chronic conditions and prevent them from occurring in the first place.
The case for transformation in care delivery
The issues related to chronic conditions are severe and complex. Managing chronic conditions is difficult as the conditions may either be connected or contribute to another. Apart from avoiding conflicting treatments, there are several cases that demand attention:
CMS stepping up chronic care management
In January 2015, CMS came up with a Chronic Care Management(3) model that offered reimbursements to providers on a monthly basis for delivering quality care services to Medicare beneficiaries with two or more chronic conditions.
However, the adaption has been slower than it should have been, with almost half the practices(4) saying they were unaware that Medicare offered reimbursement for non face-to-face interactions. Apart from that, there are several other barriers along the way:
Achieving ROI with chronic care management
There are several challenges with chronic conditions, true, but these issues are only going to grow in the coming years. It’s high time healthcare organizations analyze the financial and operational challenges and develop a simple, clear-cut plan that offers more coordination, integration, and the ability to track potential complications. Some possible steps that can be taken are:
Most of all, the emphasis should be on how can patients improve their lives. Patients are educated and aware of the conditions and the gravity and yet are unable to change their behavior. Physicians can step back and take a look at drivers that cause patients to change the course of their treatments. Physicians and care teams can improve communication with patients, interview them and allow them to participate in decision-making to engage and empower them. The aim is end-to-end population health management(6): to improve the quality of life and not just provide longevity. Only then we would be able to create(7) an impactful value-based ecosystem.
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