3 Tips To Improve Health Plans Chronic Conditions Management

As the number of Americans with chronic diseases continues to rise, health plans are constantly testing new approaches to achieve their disease management goals with fewer resources. Payers are seeking to optimize outcomes while reducing costs by implementing innovative strategies such as telemedicine, remote monitoring, and personalized care planning.

Industry leaders shared their advice on how health plans can better achieve their chronic disease management goals during a virtual panel hosted by Bright Spots in Healthcare on Thursday . Below are some key insights from the speakers.

Use data analytics to identify high-risk individuals and provide targeted interventions.

Most insurers are aware that the United States has the highest maternal mortality rate of any industrialized nation . Retika Kumar, vice president of clinical market solutions and pharmacy services at Independence Blue Cross , highlighted an initiative her company launched with the University of Pennsylvania to address this issue.

In a program called HeartSafe Motherhood, Independence Blue Cross uses data analysis to determine which obstetric patients are at high risk for preeclampsia. These patients were sent home with blood pressure cuffs and enrolled in a telemedicine program where they could talk to their providers by phone. Your providers will review your digital readings and intervene if they notice an increase in blood pressure, Kumar explains.

He cites HeartSafe Motherhood as an example of a program that not only has the potential to reduce mortality and morbidity compared to traditional care, but can be scaled up or implemented in different patient populations with relative ease.

Focused observation is a powerful tool.

Health plans should take advantage of the sophisticated remote patient monitoring tools that have entered the market in the last decade, says Sebastien Seager, CEO of Sin Health .

These tools can be used in hospital settings, for example by providing intensive care patients with wearable devices that quickly alert their care team when cardiac or respiratory failure occurs. It can also be applied to patients who are managing their chronic disease at home so that health care providers are not left in the dark about the patient's progress after discharge, Seger explained.

Overall, centralized monitoring allows providers to respond to patient needs more quickly and efficiently, which generally means better patient outcomes and lower costs, he explains.

Use the correct measurements.

When measuring progress toward chronic disease management goals, health programs can sometimes settle on the wrong metrics, Seager said. For example, health plans often focus on charging parameters, he noted.

"You can spend a lot of money refilling people's medications, but if they don't take them or don't do it right, they still end up in the hospital," Seeger said.

Instead of spending a lot of money and time on pharmacy calls and refill reminders, health plans should focus more on clinical outcomes that matter to patients, such as measuring blood sugar and blood pressure, he noted.

Photo: kate_sept2004, Getty Images

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