Chronic Care Initiative Urges Doctors, Patients, and Insurers to Collaborate on Disease Management
A new state initiative—announced by Gov. Ed Rendell on Feb. 13, 2008—would encourage those who suffer from chronic diseases to coordinate their care through a health care team and encourage insurers to reimburse physicians for the additional time spent coordinating care.
Patients with chronic illnesses often receive inadequate preventive care, partly because their primary care physicians are pressed for time, said Ann Torregrossa of the Governor's Office of Health Care Reform.
“It pays dividends to work to pay a little more to improve the time that is spent with patients before problems are exacerbated and become difficult for the patient to handle and more costly to the system,” Gov. Rendell added.
The chronic care model is based on the Wagner model for a team-based approach to management of chronic diseases.
The state’s plan—developed by the Chronic Care Management, Reimbursement, and Cost Reduction Commission—will focus initially on treating adults with diabetes and children with asthma.
Approximately 50 physicians and advanced practice nurses and their colleagues will participate in the launch through collaborative groups around the state. They will meet several times a year to train, share experiences, review data, and engage in problem solving. The first collaborative will be launched in Philadelphia this spring and others will be gradually introduced in other regions in the state.
Financial incentives for medical practices and for patients are built into the model. For example, these may include upfront payments to physicians to help them redesign their systems and enhanced capitation or fee-for-service payments. Incentives for consumers may include waiving co-pays or reducing health care premiums.
The plan will be discontinued if it does not improve the quality of health care and reduce costs, Torregrossa said.
Last Updated: 3/14/2008