Chronic Disease Patient Care Shortfalls

Premier, which started out as a hospital group purchasing organization and has added substantial consulting, software and analytics products and services, issued a report on potential savings from better management of chronic disease patients.  (Premier Report)   Premier used its data to examine 24 million emergency room visits at 750 hospitals for six common chronic disease conditions–asthma, COPD, diabetes, heart failure, hypertension, and behavioral health.   These diseases account for a very significant portion of all US health care spending.  Following on other research, Premier suggests that better management of primary and specialty care could avoid ER use, as well as that in other categories.  According to Premier, the best systems it tracks can deliver substantially better performance in use of the ER for these conditions, and if all providers hit these benchmarks, about 4.3 million visits could be avoided, saving $8.3 billion at the average cost of ER trip. Some diseases, like behavioral health and hypertension, have a greater opportunity for savings than others, such as diabetes.  Premier also identifies several strategies for provider organizations to improve care management for these diseases, which as it notes, is more important now that many of these organizations have at least some financial risk for the costs and quality of care delivered to their patient populations.  Premier’s suggestions are pretty vanilla–better care management structure and execution, patient segmentation, patient engagement and more use of analytics.  In my experience, it all comes down to the literal person-to-person execution of patient care–are the providers paying close attention to each patient’s condition and issues and ensuring that the factors influencing the patient’s use of health care are addressed.