This came out over the weekend, but Ezra Klein has an interesting long piece up about the next frontier in health management. Just as control of infectious diseases was the story of the 20th century, control of chronic diseases may be the story of the 21st:
With chronic illnesses like diabetes and heart disease you don't get better, or at least not quickly. They don't require cures so much as management....Kenneth Thorpe, chairman of the health policy and management school at Emory University, estimates that 95 percent of spending in Medicare goes to patients with one or more chronic conditions — with enrollees suffering five or more chronic conditions accounting for 78 percent of its spending.
....Health Quality Partners is all about going there. The program enrolls Medicare patients with at least one chronic illness and one hospitalization in the past year. It then sends a trained nurse to see them every week, or every month, whether they're healthy or sick....Health Quality Partners' results have been extraordinary. According to an independent analysis by the consulting firm Mathematica, HQP has reduced hospitalizations by 33 percent and cut Medicare costs by 22 percent.
Others in the profession have taken notice. "It's like they've discovered the fountain of youth in Doylestown, Pa.," marvels Jeffrey Brenner, founder of the Camden Coalition of Healthcare Providers.
Now Medicare is thinking of shutting it off.
Read the rest to learn why nurse visits work, and why Medicare may be shutting them down.