Publication

Managing patients with chronic conditions presents significant claims costs and resource burdens for health plans. Chronic diseases such as heart disease, diabetes, and cancer are the leading causes of death and disability in the United States, accounting for 90% of the nation’s $4.1 trillion annual healthcare expenditures, according to the CDC (Centers for Disease Control and Prevention, 2022). For health plans, the ongoing care required for these patients translates into increased hospitalizations, frequent doctor visits, and a high utilization of prescription medications, all of which drive up costs. Additionally, the increased strain caused by chronic patients necessitates hiring more care managers, further escalating the resource burden on health plans. The administrative and logistical complexities involved in coordinating care for these patients add to the strain, leading to potential gaps in care and reduced efficiency.

Partnering with third-party apps and patient engagement and monitoring solutions can significantly alleviate these burdens. These technologies offer continuous monitoring and real-time data, enabling early intervention and more proactive management of chronic diseases. For instance, mobile health apps can track patient symptoms and medication adherence, presenting healthcare providers with valuable insights that can prevent complications and reduce hospital readmissions. Studies have shown that patient engagement tools can improve clinical outcomes and reduce costs. For example, the American Heart Association highlights that digital health interventions can reduce cardiovascular disease risks by promoting healthier behaviors (American Heart Association, 2021). By integrating these solutions, health plans can enhance patient care, streamline operations, and achieve substantial cost savings, ultimately leading to a more sustainable healthcare system.

Incorporating third-party solutions into health plan strategies also offers more personalized patient care and more frequent touchpoints with patients between traditional doctor's appointments or outreach from care managers—allowing plans to detect symptoms earlier. This approach not only improves patient satisfaction and outcomes but also significantly impacts healthcare savings by reducing unnecessary emergency visits and hospitalizations. Health plans looking to optimize chronic disease management and enhance member engagement should consider partnering with innovative digital health solutions. By doing so, they can provide comprehensive, continuous care and realize the long-term benefits of a healthier, more engaged patient population.