Integration Of A Disease Management Contract

Not only has the cases of preventable chronic diseases increased over the years affecting half of the U.S population, they account for 86% of the health care costs. Programs and policies that address risk factors and causes of these diseases at their roots would not only promote public health but reduce the cost of health care both in treatment and hospitalization.

has the world’s most expensive healthcare system, yet one-sixth of Americans are uninsured. Approximately one-third (31%) of adults and a little more than one-half (54%) of children do not have a primary care doctor. Federal spending on healthcare in 2005 alone totaled $600 billion, a massive one-quarter of the federal budget. Someone files for bankruptcy every 30 seconds in the U.S of health concerns. And every 1.5 million families lose their homes to foreclosure due to unaffordable medical costs. The U.S. spends six times more per capita on the administration of the health insurance system than Western European nations, who insure all citizens.“ www.realtruth.org/articles/090203-005-health.html. “In United States, the annual cost of health care per capita is $5,711. http://www.visualeconomics.com/healthcare-costs-around-the-world_2010-03-01/#ixzz12f0I1lbk

Having access to quality healthcare is major part of one’s life however the cost of care has been on the rise over the past decades and continue to rise every day due to many situation such

Partners HealthCare is a non-profit, health system located in Boston that created a data based transformation (Davenport, 2013). It integrated a new system that aligned the participating organizations to cohesively run as one and to help shape the future of the organization. The system didn’t stop there as it was responsible for bettering the patient financing experience and the delivery of healthcare information to other organizations (Davenport, 2013). The initial goal of the organization was making patient care more affordable and accountable by providing integrated, evidence based, patient-oriented care.

Patients with long-term, chronic illnesses like Mr. Davis’s, care can be very costly, especially when the patient is unable to maintain routine medical care or visits and medications. Without routine medical care and maintenance medications, patients like Mr. Davis tend to have more frequent emergency room visits and hospitalizations; increasing costs for state and local government as well as tax payers. Though Mr. Davis is able to receive care during an emergency room visit, the providers are not fully aware of his health history and are only able to provide a temporary fix of his symptoms and not address his health care needs.

One of the issues is the increasing cost of healthcare which is dominating the health policy in U.S. this is accompanied by an increase in spending on healthcare. According to projections by the government, the spending on medical care will continue to rise. U.S spends more money on health care than any other nation globally (Holtz, 2013). The increase in the spending is as a result of improved tools for disease diagnosis, better surgical interventions among others. This raises an issue for the policy makers on the maximum GDP percentage that a country has to spend on healthcare, and whether the nation will afford the cost that is continually growing. In contemplating any change in the health policy, policy makers should consider the cost of the healthcare and the ability of the nation to support that high cost.

Every individual in the world deserves to enjoy health and wellness. Maintaining or achieving proper health needs enables individuals to be productive at work and leisure. Traditionally, many people have had barriers obtaining adequate healthcare due to economic constraints or personal inconveniences. Despite impressive technological advances in medicine, the challenge of delivering quality healthcare to the Americans continues to be debated amongst the nation’s political and healthcare leaders. The aging baby-boomers and the increased number of uninsured people add to the equation of population growth which results in limited access to primary healthcare for the entire public. On the

Second, the article details the five percent that is mentioned earlier. This five percent of the population accounts for around half of all healthcare expenditures. The average healthcare cost per year among this group averages to be $11,487 individually (Stanton). The people within this segment of the population tend to be a mixture of the elderly and people with one or multiple of a group of the fifteen most expensive, in terms of overall gross domestic product, medical conditions. The concentration of U.S healthcare expenditures among the top five percent of spenders becomes extremely blatant when comparing the average individual’s yearly cost of healthcare among their segment of the population. As stated earlier, the average healthcare cost per year among the top five percent of spenders averages to be $11,487 individually. That number is much greater than the average yearly healthcare spending of the bottom fifty percent of individual spenders, which averages around $664 (Stanton). The article does not state the reason for the concentration of healthcare spending among the top five percent of spenders, but it could be deduced to simply be a result of age. As people grow in age, their health tends to decline, and the array of health conditions possible for them broaden. In contrast, the bottom fifty percent of spenders are a group that encompasses much of America’s younger

Referring to the finances, the cost of treating chronic diseases and the burden to the healthcare system will continue to increase if this issue isn’t resolved. The options I am providing to you are affordable for all and as a result, will create less harm and less cost in the long run. Increased overall health means decreased expense and cost of treatments for the

"According to the National Academy of Medicine, the U.S. health care system spends around 33% of its assets, $750 billion every year, on unnecessary services and inefficient care" (Kakad, Rozenblum, & Westfield, 2017, para. 1). In a large number of the world's health care systems, uneven access to health care is coordinated by increasing expenses and divided frameworks that put weight on the healthcare providers and their patients. In light of limited spending plans and expanding costs, existing conditions are unsustainable. Several of the world's healthcare providers and patients are calling for central change, and are asking for frameworks that consider and treat patients comprehensively. Also, updated installment frameworks can support

To address the dramatic increase in chronic conditions, World Health Organisation have created Innovative Care for Chronic Conditions Framework, a

Not only do chronic diseases affect the health and quality of life of the human population, but it also the actual cost of health care and the economy. According to The Centers for Disease Control and Prevention (CDC), chronic disease make up 75% of the nation’s total healthcare spending. This mean approximately $5,300 is spent per person each year. As far as public insurance, the treatment of chronic diseases accounts for an even larger amount of the spending. For Medicare patients, it’s 96 cents per dollar and for 83 cents for Medicaid patients (Young, Saunders & Olsen, 2010). Patients with a chronic condition pay five times higher for health care than those without chronic conditions.

The healthcare system plays a key role in the economic stability of our country, as every year trillions are spent in attempt to combat disease and health issues that plaque humanity. As it makes up a significant amount of the expenditures in the economy, so the costs associated with health care of those in pain from illness and injury, including lost productivity, increased need of assistance in living and also the cost of death in some cases, is important to the economic stability and over all standard of living in our country. The key to economic prosperity is balancing the need for care with the costs of illness to keep as many people healthy and well without breaking the bank of collective society. The costs of healthcare have been increasingly problematic in recent years with so many issues surrounding the current system. With the “total health care spending in the United States expected to reach $4.8 trillion in 2021, up from $2.6 trillion in 2010 and $75 billion in 1970, meaning that health care spending will account for nearly 20 percent of gross domestic product (GDP), or one-fifth of the U.S. economy, by 2021” (Aetna). With this in mind it is apparent that as we look at the trillion-dollar industry of the medical community it seems that it needs to be a major focus of our nation as a whole and with the many issues come many creative solutions. First let us analyze the reasons behind the current cost and the major problems facing this industry and than discus what

Research has shown that individuals with chronic health conditions account for the majority of health care expenditures (Partneship for solutions, 2002). Individuals with chronic conditions such as diabetes generally use more medical care services, including hospital care, prescription medications and physician visits ( Partnership for solutions, 2002). With the increasing number of people living longer with chronic conditions such as diabetes and heart disease, the rising health care expenditures have spurred employers, health plans, and the government to look for ways to reduce health care costs and use. Health care resources should be optimally utilized for ensuring positive health outcomes for all patients (AAHP/HUAA, 2003).

The best health care systems in the world offer integrated care. Systems like the Mayo Clinic and Geisinger Health System own hospitals and labs and employ all the physicians and nurses a patient is likely to see, so they can easily integrate a patient’s care. In contrast, patients in North Carolina and throughout America typically obtain their care from a variety of independent providers. Health care expenses are paid by a variety of sources including private insurers, employers, the government and patients themselves. But unlike any other state, or even any large geographic area, North Carolina has the capacity to create a “virtually” integrated system, one that can provide the same integrated care but across an entire state. When patients’ transition between providers and health care settings, the result is often poor health outcomes, medical errors and costly duplication of tests and procedures. Through partnerships with other organizations and providers, NCHQA is seeking ways to better coordinate care and address systemic problems that cause dangerous and costly gaps in care. (NCHQA, 2014)