Integrated Health Care – A Healthy Solution For Chronic Conditions

posted by Collette Manning, Anthem

on July 7, 2017

Chronic conditions, such as type 2 diabetes, heart disease and cancer, are among the most common and costly health problems. And yet, they’re also the most preventable.

According to the Centers for Disease Control and Prevention (CDC), about half of all adults have one or more chronic health conditions — driving 86 percent of all health care spending. Look at the toll diabetes alone takes: More than 29 million Americans have diabetes, while 86 million have prediabetes. The disease was the seventh leading cause of death in the United States in 2013 (and it may be underreported). And according to the CDC, more than 20 percent of health care spending is for people with diagnosed diabetes.

I know from firsthand experience as a registered nurse that the human body is a maze of interacting, integrated systems. Not one can exist independently of the others, and together, they sustain life. While diabetes results from an imbalance of critical hormones in the endocrine system, its effects are felt throughout the body, wreaking havoc on the cardiovascular and nervous systems, as well as on vision and dental health.

If disease impacts us holistically, shouldn’t health care treat patients holistically?

So what’s the solution?

A growing trend in population health management aims to treat a patient’s whole body, not individual parts. The approach — integrated population health management (IPHM) — connects dental, vision and disability data through a patient’s benefits carriers. That connected data promotes opportunities, including early detection and improved management of chronic conditions.

Integrated health care programs more effectively coordinate medical and specialty care, making every patient-provider interaction more meaningful with richer information. These programs not only help improve patient outcomes, but can also lower medical costs over time.

For example, let’s take a look at how IPHM can help improve outcomes in people with diabetes:

  • Eye care providers can detect early signs of disease in the eye. With an integrated health plan, vision patients showing signs of early diabetes during a routine exam trigger a referral to their health plan’s care management team.
  • Patients with diabetes face an increased risk for periodontal disease, an infection and inflammation of the gums that can lead to tenderness and tooth loss. This can make blood sugar management more challenging. Some integrated health care programs, where members have medical and dental coverage, provide an extra dental cleaning for those with diabetes. Members are notified of an added cleaning — three, instead of the usual two per year — to maintain good dental health. One study found that diabetics who treated their periodontal disease through increased care had 39 percent fewer hospital admissions and 40 percent lower medical costs overall.1

The prevention, early detection and management of chronic diseases are essential to ensuring the best possible outcomes for patients, while also mitigating the cost burden. Integrated health care programs can achieve it all.

I’ll leave you with this: Every five minutes, two people die of diabetes-related causes, and 14 adults are newly diagnosed. In the time it took to read this post, the lives of at least 16 people and their families changed forever.

Learn more in the Integrated Health Care Report.

Collette Manning is Specialty Clinical Strategy Director at Anthem, Inc.

This is part of a series of six blog posts about integrated health care. Check out the previous posts and keep an eye out for the next one.
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