Fighting Chronic Illnesses with Evidence-Based Programs

Oct 14, 2014

By Rob Schreiber, MD, Medical Director, Massachusetts Healthy Living Center of Excellence

I often find myself doing things that only five years ago were being done by others. Self-checkout at the grocery store, online banking, arranging travel, self-education, and buying products over the Internet are just some of the examples that illustrate the basic fact that I must take charge.

This move to have the individual do more with less support is a new way of life. Businesses are using technology to improve efficiency and decrease costs, and educators are rethinking the way they teach with online courses becoming a staple. The perceived value proposition of these changes (quality divided by cost) seems to continue to drive innovation as the individual is pushed to do more for him/herself.

Unfortunately, when we look at patients with chronic illnesses in our healthcare system, this approach is not working. A study in 2009 by the National Council on Aging demonstrated the U.S. healthcare system is broken for millions of Americans suffering from a variety of chronic conditions, which are especially common among older adults. Successful management of chronic conditions already depends a lot on the individual, because 40 percent of health outcomes are the result of personal behaviors such as stopping smoking, being physically active, and eating well, while only 10 percent are the result of medical care. Many Americans are overwhelmed and unable to deal with the additional responsibilities foisted on them by the health care system. They want help to take better care of themselves in a way that works for them and their lives, but they do not have the tools or support to do this.

Helping patients manage their chronic illnesses is not just important for patient experience and outcomes, but also healthcare costs. Chronic illness accounts for over 79 percent of the healthcare cost in the U.S. We spend substantially more per capita on healthcare than other developed countries, yet commonly cited reports indicate that the U.S. does not have superior health system performance.

We are fortunate in Massachusetts to have the Healthy Living Center of Excellence (HLCE), which provides evidence-based programs for patients, caregivers, and families so that they can learn how to become better self-managers of their own or their loved ones’ health. These programs are now available through grant support from the John A. Hartford Foundation, the Tufts Health Plan Foundation, and the Administration on Community Living.

A model program, My Life My Health, is demonstrated to reach the Institute for Healthcare Improvement’s Triple Aim. Individuals across the country showed improvement in population health, a better patient experience, and lower cost of care. This provides a high value proposition for the Massachusetts healthcare system and providers, health insurers, and employers as well as those who are living with chronic disease. Having a more activated population also leads to better resource utilization. Individuals have better self-reported health status and are more physically active and independent, resulting in lower mortality rates, lower cost of care, and less of a burden on families and friends. This impact will allow for financial resource investment in other needed areas such as education, social services, and infrastructure projects.

You can find out more about evidence-based programs at the Healthy Living Center of Excellence to help empower adults living with chronic conditions take a more active role in their healthcare.

Together we can make Massachusetts the leader in healthy aging and chronic disease management. It would be great to hear your experiences and thoughts in this area, especially:

  • Given the value proposition of these programs, should they not be part of the basic treatment plan offered to all adults over the age of 18 managing a chronic disease?
  • How do we get patients, caregivers, medical providers, hospitals, town and state officials, as well as employers to advocate for these programs to be a covered benefit by all insurers?
  • How can we spread the word about these programs so that those who can most benefit are aware and motivated to enroll?

Please share your comments below.