2019 Hero Politico ChronicConditions 12.5.19 Primary Care

Preventing chronic illness, improving health and lowering costs: Three takeaways from POLITICO Live

With six in 10 Americans living with at least one chronic condition—and 90 cents of every healthcare dollar spent treating illnesses like diabetes, heart disease and depression—the Blue Cross Blue Shield Association and the American Academy of Family Physicians (AAFP) partnered this week to share insights, learn from other experts and hear from people working directly in communities to support the millions of Americans affected by chronic illnesses.

Here are some key takeaways:

 Primary Care is Paramount

Primary care is often a patient’s first interaction with the healthcare system, making it a leading source for treatment, prevention and better management of chronic disease. Leveraging primary care can help improve health and reduce the need for other, more intensive—and costly—healthcare services. Yet, overall, the U.S. invests significantly less in primary care than other high-income countries. According to the AAFP, when including both public and private insurance, only about five to eight percent of all U.S. health spending is on primary care, compared to 14 percent in other nations. This percentage is even lower for Medicare.   

When the investment is made to build out primary care teams to a holistic, patient-centered model of care, patient health improves and costs go down. In Kansas City, utilizing Spira Care, a one-stop-shop for integrated care, Blue Cross and Blue Shield of Kansas City is reporting a 25 percent increase in primary care visits, compared with patients who are not enrolled in Spira Care. The result: 52 percent fewer specialist appointments as well as a 41 percent reduction in hospitalizations and a 21 percent decrease in emergency room visits. And for those participating in Spira Care, the total cost of care is down by approximately eight percent.

See how other Blue Cross and Blue Shield companies are using patient-centered care to improve health.

Treat the whole patient, not just the symptoms

For too long, care delivery has focused on treating symptoms rather than addressing the underlying factors that put people at risk for developing chronic conditions. People often know what to do to improve their health, but for a variety of reasons, they are unable to act. The shift towards a more holistic approach is allowing clinicians to treat the whole patient and better understand the challenges they face in maintaining and improving their health.

According to the Centers for Disease Control and Prevention, mental illness is among the most common health issues facing Americans today, and these conditions are directly associated with increased risk of chronic disease.  Yet, across the country, access to behavioral health practitioners and affordability remain barriers to care. Integrating behavioral health services into primary care has been shown to improve outcomes and lower costs by eliminating the access barrier, reducing stigma and better equipping patients to manage their physical health needs.

Dr. Sweat, Senior Vice President and Chief Medical Officer at Blue Cross and Blue Shield of Kansas City, discusses the impact of integrating behavioral health services into primary care.

An estimated 60 percent of patient outcomes are determined by social factors. Often, patients are hindered in improving their health or better managing their chronic conditions by factors beyond their control. Access to reliable and affordable transportation, healthy foods and safe housing are common impediments to good health. Working with community organizations to extend the reach of primary care can help physicians better understand their patients’ needs and constraints beyond the four walls of the doctor’s office, and helping them access the services available can improve overall health and well-being.

Manmeet Kaur, CEO and Founder City Health Works on how learning what is happening in the patient’s home can improve treatment.

Keep the personal touch

Technology has brought great advances to healthcare, leading to improved treatments and cures.  Predictive analytics continue to advance, allowing clinicians and caregivers to anticipate patients’ needs and act early to intervene. Technology will continue to drive innovation and improvements, but healthcare remains very personal. Maintaining a human touch is critical to guide people through their care journey and provide reassurance they are not in it alone.

Dr. Greg Sweat talks about the patient’s desire for the human touch in care.

See video of the full event here.

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