Expert: Chronic disease cost too high
The Arkansas Democrat Gazette
April 21, 2009
LITTLE ROCK — Finding a way to reduce the high costs - both in deaths and dollars - of chronic disease must be an essential part of any plan to change the nation’s health-care system, a top policy expert on health care for the elderly said in Little Rock on Monday.
More than 133 million Americans, or 45 percent, have at least one chronic disease such as diabetes, heart disease, asthma or cancer, according to the federal Centers for Disease Control and Prevention.
Seven of every 10 Americans who die each year, or more than 1.7 million people, die of a chronic disease. The cost of treating patients with such diseases accounts for more than 75 percent of the nation’s $2 trillion annual medical-care costs.
Val Halamandaris, founding president of the National Association for Home Care and Hospice, said it’s only going to get worse as an estimated 78 million people in the baby boomer generation get older.
“The faster we can get our arms around this, the better,” he said. “Unless we do something, it’s going to hit us like a tidal wave. We’re going to pay the price unless we can get out ahead of this.”
Halamandaris was in Arkansas on Monday to help kick off the first Center of Excellence for Chronic Care Management Summit, hosted by Baptist Health.
He’s been involved in healthcare policy for 47 years and helped author legislation establishing the Office of Inspector General, which oversees the Department of Health and Human Services.
He spent 20 years in various roles in Congress, including as associate counsel to the U.S. Senate Committee on Aging, and as senior counsel and director of oversight for the House Select Committee on Aging.
Halamandaris described theU.S. health-care system as disjointed. Too often the 45 million Americans without health insurance get their only medical care in emergency rooms, where it’s most expensive, he said.
“We have the tale of two cities,” he said. “We have the best health care, and we have the worst.”
Politicians and policymakers in Washington “have blinders on” and are in denial about the huge costs ahead as the number of people living with chronic disease continues to grow, Halamandaris said.
Patients with chronic diseases should be treated proactively to prevent them from ending up in the hospital again and again. That’s the best way to cut costs and provide the care patients need, he said.
Baptist’s home-health program, which he referred to as “the Arkansas miracle,” should serve as a national model on how to do just that, Halamandaris said.
The Baptist Health Home Health Network model for treating chronically ill patients in their homes has garnered national attention for using technology and a collaboration of medical professionals to help patients better manage their illnesses.
It won the National Association for Home Care and Hospice’s “Excellence in Innovation Award” last October and a “Spirit of Excellence for Quality Award” in December from Modern Healthcare, a health-care business magazine.
The network has about 800 patients and serves residents within 30 miles of Heber Springs and 50 miles of Little Rock, North Little Rock and Arkadelphia. Chronically ill patients are given small telehealth computers, which they use to check their own vital signs such as heart rate, blood pressure, oxygen and blood-sugar levels.
The information is sent through a secure network to Baptist’s offices, where they’re monitored constantly by nurses. If there’s an issue, the nurses can call a doctor or send a nurse or ambulance to the patient’s home.
In addition to the computers, nurses visit patients in their homes a few times a week, talk with them about their health, eating and sleeping habits and teach them how to best manage their chronic diseases.
Beth Hennessey, administrator of the network, said the key is responding to patients’ needs, rather than trying to make patients fit into a pre-existing system.
But some changes in the national health-care system are needed before Baptist’s model can be used to its full ability, she said. One problem is the Centersfor Medicare and Medicaid Services limit home-health services to 60 days unless a patient can’t leave home without “considerable and taxing effort.”
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