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The Value of Chronic Disease Care and Population Health Management for Healthcare

For healthcare, balancing the focus on patient outcomes with that on financial considerations is often difficult. The benefits of focusing on chronic disease care and population health for patients, healthcare providers, and payers is a focus of the HealthStream webinar, “Treating an Aging Population: An Effective Approach to Addressing Chronic Conditions,” from our three-part series, “Managing Opioids, Pain and Chronic Disease: Critical Steps in Addressing Population Health.” The webinar was presented by Robin Rose, Vice President of the Healthcare Resource Group, HealthStream, and Robyne Wilcox, Senior Director of Continuum Research, HealthStream.

The Population Health Initiative

According to Wilcox, a major initiative occurring in healthcare is the “increased focus on population health across the continuum of care, with adoption on the rise in every setting, from hospitals and health systems all the way to home health and hospice.” In essence, providers are taking a more proactive approach to care for those with chronic conditions, which is resulting in better patient engagement. Not only are patient interactions becoming more meaningful, but cost savings for care are involved. Wilcox shared that now “CMS recognizes that chronic care management is really the key to lowering healthcare costs.”

Reducing Care Costs and Readmissions

As an example, Wilcox mentioned a 2017 study by the Agency for Healthcare Research and Quality (AHRQ) that found “patients who have a clear understanding of their after-hospital care instructions, like how to take their medication and how to make follow-up appointments, are about 30% less likely to be readmitted or end up in the emergency room.” The value of chronic care management and providing additional support to patients during their most vulnerable state cannot be underscored enough. Also, “CMS has made it possible for providers to get paid for the extra time and the extra resources it takes to support patients with chronic or long term conditions.”

Alignment of Patient Care and Financial Interests

Not only is the focus on chronic disease care better for patient outcomes, but it is a win for everyone on the financial side as well. After a CMS study “found that there were a lot of health benefits as well as revenue benefits” to the practice, “Medicare instituted a separate payment under the physician fee schedule for chronic care management of any Medicare patient.” At the same time, “payers can actually save almost a thousand dollars per member every year.” Even patients can benefit financially, with one “study estimating that patients can save an average of $200 per year” from coordinated management of their chronic conditions. According to Wilcox, “the value of chronic care management involves savings for every one across the board. The key though to earning the savings is about prevention, education, and proactive management of those conditions.”

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