Integrating Chronic Disease Management With New Health Delivery Mechanisms

July 20, 2012
71 Views

We’ve long known that the key to addressing our greatest 21st century health care challenges – controlling costs while achieving improved health outcomes – lies in attacking chronic disease. With the implementation of health reform, the question we’re facing is how to mesh this goal with new health delivery mechanisms, such as accountable care organizations (ACOs), designed to move our U.S. health care system from a fee-for-service orientation to one based on value.

 

We’ve long known that the key to addressing our greatest 21st century health care challenges – controlling costs while achieving improved health outcomes – lies in attacking chronic disease. With the implementation of health reform, the question we’re facing is how to mesh this goal with new health delivery mechanisms, such as accountable care organizations (ACOs), designed to move our U.S. health care system from a fee-for-service orientation to one based on value.

 

A paper published in this month’s issue of the American Journal of Managed Care provides important insight into how value-based care can, in fact, lead to improved disease treatment and prevention while also containing cost growth.

The report, The Role of Pharmaceuticals in Value-Based Health Care: A Framework for Success, was developed by experts from the National Pharmaceutical Council, American Medical Group Association, Premier healthcare alliance and seven of the nation’s leading health providers. Their work makes the critical point that pharmaceuticals are an essential component in minimizing costs and achieving overall health objectives.

And, from the PFCD standpoint, medications are an essential element in attacking chronic disease and making our health system more cost-effective.

The paper’s authors make valuable points about how to make optimal use of pharmaceuticals in value-based care, specifically:

  • We cannot treat medications as an isolated expense, a separate “silo” of care. Drugs have to be viewed as an integral part of the patient care continuum.
  • There is no such thing as a “one size fits all” approach to medication therapy management. Achieving best outcomes, both clinically and economically, hinge on shaping therapy according to the patient’s condition.
  • It is essential to use composite risk to identify patients who are vulnerable to drug-drug, drug-disease or polypharmacy concerns.
  • If an ACO or other value-based system has incentives to achieve cost savings, there must be a metric to detect underuse of pharmaceuticals. Underuse can lead to exacerbated conditions and greater costs in the long run.

As the dialogue on how to achieve value-based care continues, policymakers and providers would do well to heed the words of one of the paper’s authors, National Pharmaceutical Council Chief Science Officer Robert Dubois, M.D., who said, “It is crucial for ACOs to view prescription drugs as a tool, not simply an expense.” In combating chronic disease, this is a vital approach

Link to paper http://www.npcnow.org/Public/Research___Publications/Publications/pub_cer/ajmc_article_july2012.aspx

You may be interested

The AI Healthcare Revolution: Will AI Soon Replace Your GP?
Medical Innovations
59 shares430 views
Medical Innovations
59 shares430 views

The AI Healthcare Revolution: Will AI Soon Replace Your GP?

jasmine.morgan - July 28, 2017

There is an alarming situation in the medical world: an unparalleled increase of available information, compounded by an unprecedented shortage…

The Top 6 Ways You Can Immediately De-Stress
Specialties
474 views
Specialties
474 views

The Top 6 Ways You Can Immediately De-Stress

Jenn Ryan - July 27, 2017

Stress feels like it happens so fast and then takes so long to go away. It’s an instant of something…

Healthcare Security: HIPAA Standards and The Challenges of Securing Mobile Data
Policy & Law
29 views
Policy & Law
29 views

Healthcare Security: HIPAA Standards and The Challenges of Securing Mobile Data

David - July 26, 2017

“$2.5 Million Settlement Shows That Not Understanding HIPAA Requirements Creates Risk” — HHS press release, 2017 That is the title…