Managing the cost and care associated with chronic conditions remains a top priority for both payers and providers. Consider the facts:
- The prevalence of chronic conditions:
- Half of all adults have one chronic condition.
- A quarter of all adults have two or more conditions.1
- The impact of comorbid behavioral health and medical conditions:
- 86% of the country’s $2.7 trillion in annual healthcare expenditures are for people with chronic and mental health conditions.2
- Average annual costs, including medical, pharmaceutical and disability costs, for employees with depression may be 4.2 times higher than those incurred by a typical beneficiary.3
- The rate of noncompliance to prescribed treatments is three times greater with depressed patients4
While conditions like diabetes, heart disease, and asthma account for a significant portion of U.S. healthcare spending, they are often preventable or manageable through lifestyle choices, early detection, and proactive care. As a result, the shift to value-based care has prompted healthcare organizations to look beyond chronic condition management and get the bigger picture on factors affecting their patient populations like identifying opportunities for preventative care.
This movement toward population health—monitoring groups or individuals across the care continuum—requires increased data collection, sharing, and collaboration between payers and providers to align and achieve goals.
Often, data is fragmented and housed in multiple disparate systems, creating inefficiencies and missed opportunities to intervene and engage with at-risk individuals before chronic conditions develop. The power of prevention can be found in turning knowledge into action. Advanced analytics not only helps organize disparate clinical, financial, and operational data, but also offers a more holistic view of patients—identifying targeted opportunities to close gaps and deliver quality, coordinated care.
There are three key ways MedeAnalytics Population Health can help manage chronic conditions:
- Look for specific markers indicating that a patient is potentially at risk for a chronic condition
- Identify areas that could be problematic in specific sub-populations such as medication non-compliance
- Monitor effectiveness of care management and wellness programs
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In the evolving landscape of healthcare, the transition to value-based care stands out as one of the most pivotal initiatives.…Read on...