The Chronic Care Crisis and Your Way Forward
Here we are. It’s the year 2016, and we have yet to receive jet packs or flying cars. But we DO have one thing no historian predicted—an unprecedented chronic health care crisis. Cancer, stroke, obesity, diabetes and heart disease, to name a few, are currently the most common, and the most costly, of all health concerns. They’re also the most preventable.
The causes of this crisis are different, depending on who you ask. Scientists point to lack of exercise. Other experts point to lifestyle choices—alcohol abuse, smoking or poor diet. Still others blame the chronic stress of modern lifestyles, or the genetic lottery. Luckily, health care has been moving forward with strategies to counteract the chronic care struggle. But before we can plot a course forward, we have to understand how we got here.
As the population of older adults in the U.S. grows over the next few years, we have an opportunity to turn the tide. The approaches we use to countermand the chronic disease crisis will have to consider the challenge on many levels, and from many angles. Here are just a few of the ways health care is working to effect a change.
Changing the focus of health care from “right now” to “life-long care.”
Our health care system was designed to deliver acute care—and historically, that makes sense. For the majority of the American hospital’s existence, most treatment delivered was aimed at acute diseases. As we left the era of infectious disease behind, our model of care did not shift along with our major challenge.
Today, the medical community is putting greater emphasis on preventive care, and on care models that strengthen the relationships between providers and patients. Together, these two efforts are working to achieve the same goal—patients who know how to better manage their health, and actually do it.
As providers put more focus on preventive care and screening for disease, signs of illness are spotted earlier. This also gives patients the tools and information they need to avoid lifestyle risks before they become chronic illness. This long-term investment in individual health is one aspect of better care delivery.
What can you do?
- Consider an investment in a health plan that emphasizes total-person, whole-life wellness—look for details on the use of data to proactively spot gaps in care, as well as approaches that work to keep healthy people healthy.
- Look for the “extras”—psychologically based smoking cessation plans, support for employees at difficult times of life such as pregnancy and birth, dealing with stress and substance abuse. Plans that proactively help at these times can make a big difference.
Collaborative, data-driven care delivery
Collaborative, team-based care and the adoption of the medical home approach are a few of the ways that population health has been improved over the last few years.
Another key to driving true change is greater access to biometric data, and a greater push to translate this data into actionable insight that closes costly care gaps. Today, health care companies use ever-stronger algorithms to identify health issues and deliver personalized messaging. From the at-risk to those suffering from specific combinations of chronic illnesses, patients in need of intervention are spotted sooner, and connected with the care they need.
What can you do?
- Look for the word “team.” When you’re making health plan decisions, look for plans that emphasize team-based care, and offer proof points around the delivery of comprehensive care by integrated, multi-specialty care teams.
- Proactive care, especially for the chronically ill, is another topic to watch for. Ask questions around how member and population data is translated to real-world interventions, and what the savings could be for a business of your size.
Community and one-on-one support
Although many of the causes of chronic illness (smoking, inactivity) are common knowledge, the challenge is to help individuals apply that knowledge to their own lives. For many individuals with one or more chronic illness, simply knowing the steps to take toward better health is not enough for effective self-management.
Health care has developed a new focus on proactive care management, and on one-on-one support through the primary care nurse model. These approaches effectively help the patient build skills while navigating an often-complicated system of care. From education to oversight of appointment scheduling, these approaches help the patient stay on track and deliver the kind of personal support that sets them up for future success.
What can you do?
- Ask your health plan’s representative about one-on-one support for chronically ill members. Do primary care nurses communicate directly with members and their families? How well do the primary nurses know the company’s benefits in order to connect members with the right care?
- Data, data, data—and how it’s delivered. Look for health plans that work to turn member data into answers and to deliver those answers in a way that’s empowering to employees, not invasive.
We know the sources of our chronic care crisis. We are developing and refining approaches to eradicate it. Although chronic illness will always be a part of the picture, our collective health care future doesn’t look bleak.
The way forward is working together—it is collaboration not just between care providers, between policymakers, communities, businesses, health care providers and individuals. Where all these approaches and entities come together, there will be answers—and better health.
- Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 07 Dec. 2015. Web. 18 Feb. 2016.
- “Worker Productivity.” gov. N.p., n.d. Web.
- Koh, Howard K., M.D., M.P.H. “The State of Chronic Disease Prevention.” HHS.gov. N.p., 12 Oct. 2011. Web.
- Improving Primary Care for Patients With Chronic Illness—The Chronic Care Model, Part 2 .Thomas Bodenheimer, MD; Edward H. Wagner, MD, MPH; Kevin Grumbach, MD JAMA. 2002.