Our current health system presents multiple challenges to effective
and efficient care of chronically ill patients. First, the fragmented
nature of our system means patients have multiple care providers who
don’t communicate with each other, and are not individually or
collectively responsible for patients’ whole care. Second, health care
is centered around care in a doctors’ office or hospital, while
evidence shows the overwhelming proportion of the care needed by
chronically ill patients is self-administered.1
Third, our predominant provider payment systems reward high-cost
medical interventions over higher-value primary care; they reward
volume of care over quality of care. Fourth, the trend toward patients
assuming higher burdens of cost sharing (i.e. deductibles and co-pays)
in the predominant health insurance market creates disincentives to
patient utilization of chronic disease diagnosis and treatment services
that contribute to effective disease management and cost control.
With 75% of all US health expenditures associated with treatment of chronic disease2 and 2/3 of cost increases driven by the rising prevalence of it,3,4
there is little disagreement that growth in America’s health costs
cannot be effectively managed without reforming the delivery of chronic
disease care. Innovations in health care delivery that address the
sources of current costly inefficiencies and ineffectiveness in health
care delivery focus principally on: a) coordination of care utilizing a
team approach known as “The Patient-Centered Medical Home” and b)
restructuring provider and patient incentives to reward provision of
high quality, cost effective care and encourage patient utilization of
it.
Our current health system presents multiple challenges to effective
and efficient care of chronically ill patients. First, the fragmented
nature of our system means patients have multiple care providers who
don’t communicate with each other, and are not individually or
collectively responsible for patients’ whole care. Second, health care
is centered around care in a doctors’ office or hospital, while
evidence shows the overwhelming proportion of the care needed by
chronically ill patients is self-administered.1
Third, our predominant provider payment systems reward high-cost
medical interventions over higher-value primary care; they reward
volume of care over quality of care. Fourth, the trend toward patients
assuming higher burdens of cost sharing (i.e. deductibles and co-pays)
in the predominant health insurance market creates disincentives to
patient utilization of chronic disease diagnosis and treatment services
that contribute to effective disease management and cost control.
With 75% of all US health expenditures associated with treatment of chronic disease2 and 2/3 of cost increases driven by the rising prevalence of it,3,4
there is little disagreement that growth in America’s health costs
cannot be effectively managed without reforming the delivery of chronic
disease care. Innovations in health care delivery that address the
sources of current costly inefficiencies and ineffectiveness in health
care delivery focus principally on: a) coordination of care utilizing a
team approach known as “The Patient-Centered Medical Home” and b)
restructuring provider and patient incentives to reward provision of
high quality, cost effective care and encourage patient utilization of
it.