Disease Management: A Significant Tool in Restructuring the Government’s Healthcare Expenditure and Improving Quality of Health

Disease Management:  A Significant Tool in Restructuring the Government’s Healthcare Expenditure and Improving Quality of Health

For the past several years, the US government together with its people has been struggling to keep up with the continuous rise in the costs of healthcare.  Last 2007, according to the Centers for Medicare and Medicaid Services, Office of the Actuary, National Health Statistics Group the national healthcare expenditure reached an alarming amount of $2.4 Trillion with the hospitalization cost accounting for the largest percentage of all health expenditures of 31% followed by the cost of Physician services and Prescription drugs of 21% and 10% respectively.  Expert analysts even projected that healthcare cost will continue to rise for next years if the US government’s healthcare expenditure is not restructured.  Because of this pressing issue, U.S. President Obama has made the move to restructure the current healthcare cost with control over health expenditure as its main emphasis.

So what really drives the healthcare expenditure to grow this large?  There are many contributing factors that can impel growth of expenditure and one of these can be attributed to chronic disease conditions.  The prevalence of chronic disease has placed enormous pressure on the healthcare system, which further intensified the demand for management and treatment of continuing illness and enduring healthcare services such as resident homes and rehabilitation centers.  Because of this, a strategic tool known as disease management healthcare plan has been established.  This tool will be the key element in reforming healthcare finances.

Disease management is a systematic approach to healthcare that is primarily focused the management of chronic diseases like congestive heart failure, diabetes, coronary artery disease, chronic obstructive pulmonary disease, end-stage renal disease, asthma, obesity and hyperlipidemia.  It also includes the implementation of systems such as patient outreach programs, compliance to treatment, service organization, patient registries, patient teachings, data sharing and practice guidelines;  with the latter being used as a clinical pathway that leads to the road of effective disease treatment, economical means of purchasing medical supplies and improved quality of health.

The integration of as disease management in the healthcare system as a mean to manage healthcare expenditure, seeks to curb avertable occurrences like exacerbation of disease conditions that might necessitate acute medical attention and hospitalization by allowing the patients to be responsible in understanding the complexity of their chronic ailment and find ways of take care of themselves, and by taking full advantage of patient adherence to evidence-based practice guidelines, recommended treatments and behaviors that advocate health.

The outcome of was noted to have agreeable consequences of improving health status of the patient, provision of high quality health care, patient and provider satisfaction, improved clinical outcomes, improved functional ability and lower cost of healthcare, as well as the need for hospitalization  was greatly reduced and care support can now be easily accessed.  Disease management even advocates physician-patient relationship through shared decision making.

Nowadays, private sectors like CareNet have incorporated disease management in their healthcare system.  CareNet is known to have significant and substantial experience in the arena of healthcare and has been offering aid to health insurance payors and other government agencies in realizing the significance of containing costs especially now that Medicare and Medicaid enrollments are growing.

CareNet’s  Disease Management Program involves the process of identifying the population with chronic disease, implementation of evidence-based practice guidelines, collaboration among the health advocates, patient education, continuous evaluation and provision of feedbacks to motivate patient cooperation to current regimen.  CareNet believes that improving the overall quality of health of a chronically ill individual will enhance the quality of life, thereby lowering the cost of care.