Posts Tagged ‘Stanford Chronic Disease Self Management Program’

Multiple Chronic Conditions- an Expensive Public Health Threat

October 17th, 2011

I’ve written several pieces over the last few weeks highlighting our efforts to better integrate primary healthcare into the treatment plans for folks with mental illnesses- but the issue of providing better coordinated care for folks with multiple chronic medical conditions is really far bigger than this integration issue.  More than 25% of Americans have multiple chronic conditions like arthritis, asthma, chronic respiratory conditions, diabetes, heart disease, and high blood pressure.  Treating folks with multiple conditions is both complicated and expensive- and more coordinated efforts are a key to improving both.  In fact, 66% of all health care spending in the US goes toward caring for the 27% of folks with co-occurring chronic medical conditions. 

The US Department of Health and Human Services (HHS) knows full well that better care coordination for these folks is critical if the nation is going to do a better job of improving health care efficiency and containing costs.  There are a number of efforts underway to address these issues- many of which are summarized in a strategic framework document that HHS put out a few months ago called Multiple Chronic Conditions: A Strategic Framework.  The framework is just that- an outline of a strategy- and it includes a vision statement, goals, objectives, and discrete strategies to guide HHS in coordinating its efforts internally and collaborating with stakeholders externally. 

By the way, our tobacco & chronic disease team is leading the state’s efforts to help folks better manage their illness.  One of their tools is the Stanford Chronic Disease Self Management Program- which is an evidence-based program which empowers folks to recognize and address the factors which impact their chronic conditions.  Through Healthy Living, individuals can develop and implement personalized action plans, take ownership, and achieve improved health outcomes that are both manageable and sustainable.  Our team (under the leadership of Ramona Rusinak) and the Arizona Living Well Institute has identified this as a core element of its overall strategic direction.

Incentivizing Chronic Disease Self-Management

April 12th, 2011

This month AHCCCS told us that they’ve picked our Bureau of Tobacco & Chronic Disease as the state applicant for HHS’ Medicaid Incentives for Prevention of Chronic Diseases Grant.  The grant proposal (which will be developed with AHCCCS) must be turned in to the Centers for Medicare and Medicaid Services early next month.  The grant is competitive, so we’re not certain whether we’ll be successful, but we like our chances.

The idea is to incentivize AHCCCS members to participate in the evidence-based Stanford Chronic Disease Self Management Program, which provides opportunities for members to build skills and gain the confidence to actively participate in their health management.  Our team would build on the current infrastructure and capacity to deliver workshops to include AHCCCS members through expansion of partnerships offering workshops in local communities across Arizona.

The program that we’ll be proposing will create rewards for incremental successes in the disease self-management process, including enrollment in program “adherence” and demonstrated reduction in risk factors (e.g. blood pressure, cholesterol and glucose levels, weight, and tobacco use).  The program would conduct assessments at client progress at 30, 60, and 90 days, and will conduct an analysis of continued reductions and/or maintenance after 12 months.  The specific rewards will be determined on the basis of focus groups findings conducted with adults with chronic disease.  There’s strong evidence that this program design is critical to promoting and enhancing disease self-management efforts, and improving the overall health and cost burdens of this population.