Lessons Learned In Coordination of Care
The Growing Demand for Sophisticated Care Management
The care management movement began with the management of episodes of care and is now migrating toward managing the health of an entire population.
Healthcare often stands out as the least efficient industry in the world (as illustrated in Figure 1 below from a recent IBM thought leadership study), with more than $2.5 trillion wasted annually. Approximately 30% of overall healthcare spending in the U.S. is deemed unnecessary. As different initiatives have been implemented over the years to combat this extent of unnecessary utilization, care management programs have evolved considerably.
A nationwide survey of physician organizations undertaken by researchers at the University of Chicago1 and University of California-Berkeley noted that “millions of patients with chronic diseases do not receive quality care because, in large part, effective care management processes are not being practiced.” The researchers found that physician groups on average use only 32 percent of 16 recommended care management processes. One physician group in six uses none. These processes include using nurse case managers to maintain contact with patients; teaching patients how to understand and care for their illness at home; keeping a list of patients with each disease; developing timely reminder systems for patients and caregivers; and providing feedback to physicians on the quality of their care.