A Primer on Managed Care: Multiple Chronic Conditions
Medicaid Services’ Medicare Diabetes Preven- tion Program (tinyurl.com/ycs3n8l8) and the American Diabetes Association’s Diabetes Pre- vention Program (tinyurl.com/yaf3738d ) , both of which have been proven to promote weight loss, reduce blood pressure, and improve lipid
interventions? Historically, those on commer- cial, employer-based plans changed plans every three to five years, there was little incentive for providers to invest in the most effective condi- tion-management programs. Perhaps the great- est contribution of the ACO movement, when it comes to both preventive care and condition- management programs, is that financial incen- tives are better aligned toward doing what is best for people, and that providers are being encour- aged to move from reactive to proactive care. Robert Fields, M.D., M.H.A., is senior vice president and chief medical officer for Population Health at Mount Sinai Health System in New York City. Fields is a director on the board of the National Association of ACOs, chairs the Quality Committee, and is a member of the Policy Committee. He also serves on the board of America’s Physicians Groups.
Individualized education can influence behavior.
profiles. Programs like these are resource-inten- sive in the short term, but that reality pales in comparison to the astronomical costs of caring for an aging, increasingly overweight, and at- risk population. Though there is a growing body of evidence about what works to manage chronic condi- tions, the question is, who will pay for these
References Barello, S., et al. 2016. “eHealth for Patient Engagement: A Systematic Review.” Frontiers in Psychology doi: 10.3389/fpsyg.2015.02013. Chiauzzi, E., et al. 2015. “Patient- centered Activity Monitoring in the Self-management of Chronic Health Conditions.” BMC Medi- cine 13: 77.
Simmons, L. A., et al. 2014. “Patient Engagement as a Risk Factor in Personalized Health Care: A Sys- tematic Review of the Literature on Chronic Disease.” Genomic Medicine 6(2): 16.
Greer, N., et al. 2015. “Pharmacist- Led Chronic Disease Management: A Systematic Review of Effec- tiveness and Harms Compared to Usual Care .” Annals of Internal Medicine doi: 10.7326/M15-3058 (ePub ahead of print).
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