Chronic Diseases Account for $3.00 out of every $4.00 spent on Healthcare
“More than 40% of Americans have one or more chronic conditions, and people with chronic diseases account for 75% of health spending in this country. About 58 million nonelderly adults have at least one chronic condition. About 60% of people with chronic disease are working-age adults,” according to a recent study published in Health Affairs.
Hypertension, diabetes and pulmonary conditions, such as asthma, are contributable to high dollar claims in an employer’s benefit plan. Many of these patients tend to be non-compliant: not taking prescribed medications, lack of adherence to doctor’s orders, and self denial (believing that I am not like the rest of the people that have this disease). Patients also tend to use lack of time or lack of financial resources as excuses not to take preventative measures to prevent future progression of their disease.
A really positive step is having an employer that is supportive of his employees by making resources available at the workplace. Implementing a well managed disease management program is one of the steps that an employer can take to show the employees that the company is concerned for their well being and state of health. A program should provide a disease management specialist, who is also a registered nurse, to each patient, to educate the patient on their disease and positive steps that can be taken to achieve self management and compliance. Dr. Michelle Heisler, an associate professor of medicine and health behavior at the University of Michigan calls for “a team based approach, saying that patients need systematic follow-up and assessment tailored to their clinical severity. High-quality chronic care requires a systematic and organized approach with a lot of coordination and collaboration between all of the doctors and nurses a patient sees.”
Information without follow-through is ineffective. Patients are more responsive if they have an individual that they must be accountable to. The disease management specialist contacts the patient at regular intervals, especially as follow-up to doctor’s appointments. Set backs are also part of the process. Hopefully barriers to change are addressed and overcome. Gradually lifestyle changes can be made that positively impact the disease process . It is a collaborative approach.
Patients can become motivated to self manage their diseases. By reducing health risks, claim costs to the employer can be reduced and future disease can be prevented. The goal of the employer is to implement programs that positively impact the bottom line.
