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Health Experts Call Chronic-Disease Management Key to Controlling Costs

Efforts to coordinate care, encourage patients to take medications cited as potential strategies.

Cathleen Bennett, director of state health policy and strategic planning, and state Sen. Joseph F. Vitale, chairman of the Senate Health, Human Services and Senior Citizens Committee.

While warning that New Jersey residents face a bleak health future if the state’s healthcare system doesn’t improve management of chronic diseases, a panel of experts agreed yesterday that positive steps are already occurring to improve the situation.

Those steps include improving coordination of patient care, expanding patient health records, encouraging patients to take appropriate medications and helping caregivers deal with their own health problems.

State Department of Health official Cathleen Bennett, speaking during the HealthCare Institute of New Jersey panel discussion held in Monroe, said there could be dire consequences if chronic health conditions aren’t addressed.

“This could be the first generation that doesn’t live as long or longer than their parents,” said Bennett, who noted that 188,000 New Jersey children have asthma and that percentage of obese state residents is projected to rise from 24 percent to as high as 48.6 percent by 2030.

Both Bennett, the director of state health policy and strategic planning, and New Jersey Association of Health Plans Vice President Sarah McLallen emphasized the importance of new health delivery systems in addressing these chronic conditions.

A crucial part of this change is the shift from traditional delivery models to accountable care organizations – in which insurers attempt to compensate providers for how well they perform and keep costs down, rather than for each service they provide.

Bennett also said that workplace wellness programs, supported by the state program Shaping NJ, are helping to improve employee fitness and health.

New Jersey Health Care Quality Institute President and CEO David L. Knowlton noted the challenges in improving children’s diet and exercise. His organization has worked on a “no child left inside” program with city governments.

“My concern is that people recognize that this is a competitive program: You are competing with products that are alluring, that taste good,” Knowlton said.

Bennett also said expanding electronic health records will help in the management of chronic conditions. She compared the improvement in patient records – which frequently begin with only one provider or hospital -- to the early days of ATMs, which began with people only able to use cards issued by their banks in bank lobbies during bank hours, but expanded over time to a much wider network.

“We think it’s going to drive significant innovations,” Bennett said of the expansion of health information organizations, which share electronic records.

McLallen said the state’s insurers have instituted several programs aimed at chronic diseases, including initiatives by Aetna and UnitedHealthCare to make it easier for members to keep track of their health records; AmeriHealth offer of financial incentives to members who complete health-risk assessments; and Horizon Blue Cross Blue Shield of New Jersey’s expansion of patient-centered medical home model in which providers coordinate patient care.

In addition, the 2010 Affordable Care Act eliminates copayments for wellness visits, McLallen noted.

National Consumers League Vice President Rebecca Burkholder said her organization has launched a national campaign to encourage patients to take their medications as directed.

Sen. Joseph F. Vitale (D-Middlesex) said it’s going to take a sustained effort to convince his fellow legislators and state officials to spend the money necessary for programs to combat chronic conditions. Making this investment now will save the state more in the long run, he said. Vitale, chairman of the Senate Health, Human Services and Senior Citizens Committee, cited smoking-cessation programs as an area where the state should invest more funds.

“We need help, we need support, we need to build the case,” Vitale told a crowd of roughly 70 people gathered at Forsgate Country Club, including health policy advocates and pharmaceutical company executives.

Vitale said another potential strategy to improve chronic disease management is to give more independence to advanced practice nurses.

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