Chronic Care Management Facts

What is Chronic Care Management?
Chronic care management is an approach to improving healthcare for people living with chronic illnesses such as diabetes and heart failure. Effective programs help patients avoid complications and hospitalizations by providing them with disease management services, education, tools and resources that encourage them to take an active role in managing their health. Programs also support physicians by providing resources and expertise to help them care for their chronically ill patients.

The Magnitude of Chronic Illness

• More than 133 million Americans live with chronic illnesses. ¹
• Chronic diseases account for 70 percent of all deaths in the United States.¹
• Nearly 80 percent of Medicare beneficiaries have at least one of the following chronic conditions: stroke, diabetes, emphysema, heart disease, hypertension, arthritis, osteoporosis, Parkinson's disease or urinary incontinence.²

The Cost of Chronic Illness

• The medical care costs of people with chronic diseases account for more than 75 percent of the nation's $2 trillion medical care costs.¹
• The costliest five percent of Medicare beneficiaries account for about half of all Medicare spending each year. Among this top five percent, 47% had congestive heart failure and 35% had diabetes.³
• In 2008, the cost of treating heart disease and stroke in the United States is projected to exceed $448 billion.⁶
• The estimated cost of diabetes in 2007 was $174.8 billion. Of this amount, 116 billion was due to direct medical costs and 58 billion to lost productivity.⁸

The Power of Disease Management
Care Improvement Plus' care management program is based on a disease management model XLHealth has successfully implemented for Medicare Advantage health plan clients over its eleven year history.

Over a two year period, XLHealth realized notable improvements in significant clinical outcomes for approximately 12,000 Medicare Advantage plan members with diabetes and/or heart failure, including:

• A 21 percent reduction in the number of inpatient hospital admissions
• A 25 percent decrease in the number of participants with "poorly controlled" blood sugar levels
• A 19 percent decrease in the number of participants with poor control of their LDL (bad) cholesterol levels

In addition, the program increased adherence to recommended best practices aimed at reducing participants' risk of developing complications, including:

• A 25 percent increase in the number of participants taking an ACE Inhibitor medication to reduce their risk of cardiovascular complications
• A 20 percent increase in the number of participants taking a Beta Blocker medication to reduce their risk of cardiovascular complications

SOURCES:

• ¹ CDC National Center for Chronic Disease Prevention and Health Promotion: Chronic Disease Prevention http://www.cdc.gov/nccdphp/overview.htm
• ² Berenson R, Horvath J. Center for Medicare Advocacy, Inc., Conference on Medicare Coordinated Care. The Clinical Characteristics of Medicare Beneficiaries and Implications for Medicare Reform. March 2002. Retrieved from: http://www.medicareadvocacy.org/chronic_PartnerPaper_ClinChars.htm
• ³ Lieberman S, Lee J, Anderson T, Crippen D. Reducing the Growth of Medicare Spending: Geographic Versus Patient-Based Strategies. Health Affairs–Web Exclusive, W3-603. December 10, 2003. Retrieved 1/21/05 from http://content.healthaffairs.org/cgi/reprint/hlthaff.w3.603v1
• ⁴ American Heart Association. Heart Disease and Stroke Statistics–2008 Update. Dallas, Texas: American Heart Association; 2008. http://www.americanheart.org
• ⁵ The Power of Prevention, a report by the U.S. Dept. of Health and Human Services (2003) found on the CDC Web Site (http://www.healthierus.gov/steps/summit/prevportfolio/power/index.html
• ⁶ Preventing Heart Disease and Stroke: Addressing the Nation's Leading Killers. At A Glance 2008 http://www.cdc.gov/nccdphp/publications/AAG/dhdsp.htm
• ⁷ Prevention Works:CDC Strategies for a Heart-Healthy and Stroke-Free American. 2006. http://www.cdc.gov/dhdsp/library/prevention_works/index.htm
• ⁸ Direct and Indirect Costs of Diabetes In the United States, American Diabetes Association, 2008 http://www.diabetes.org/diabetes-statistics/cost-of-diabetes-in-us.jsp

This page was last updated on: 7/9/2010 9:59:15 AM