Humana: Chronic Treatment is Not 'One and Done'

(Originally published on Humana.com)


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As chronic medical conditions continue to rise in America, the problem is made worse by a “complicated health care delivery system that’s neither consumer centric nor easy to navigate,” said Dr. Roy Beveridge, Humana’s Chief Medical Officer.

He wrote an article forNEJM Catalyst,making the case for a more holistic approach to care.

“Fragmented. Inefficient. Episodic. These terms are frequently used to describe the U.S. health care system, which was not designed to handle the fact that three out of four Americans aged 65 and older are living with multiple chronic conditions,” Dr. Beveridge wrote. “If we want this system to effectively handle the chronic disease epidemic, we must evolve our clinical mind-set and fee-for-service reimbursement structure from the episode-driven ‘one-and-done’ system to a consumer-centered, integrated care approach supported by value-based reimbursement.”

He noted that Americans have developed unhealthy habits like poor diets and a lack of exercise that have fueled the growth of chronic conditions such as diabetes, coronary artery disease, congestive heart failure, and chronic obstructive pulmonary disease. Combatting that requires a fresh approach and more preventive care.

“The path to value must move beyond the transaction-driven, fee-for-service approach that has been the foundation of the U.S. health care system for decades,” he wrote. “Health care professionals must spend time educating and engaging their patients, and must be incentivized to do so in a value-based agreement. A value-based approach that builds a strong relationship between the physician and the patient and recognizes that health is local and happens outside the doctor’s office is the best approach to solving the chronic-condition epidemic of the 21st century.”

Read the full article here.

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