Placing the Consumer First - The business model of the Digital Health Plan places the consumer at the heart of the strategy. Chronic Disease Management offers opportunities for states to better integrate and manage chronic illness for Medicaid beneficiaries. States can and should exercise creativity and flexibility in the bidding and contracting process for innovative chronic disease management programs. The disease management industry is responsive to state-sponsored programs serving Medicaid beneficiaries. Moving from demand management to disease management may require different relationships with physicians.
Physician participation is critical to success.
States should consider mandatory enrollment in chronic disease management programs. The use of new primary care models to manage care for the chronically ill can play a significant role in reducing and preventing the debilitating consequences of illness, can help consumers navigate an increasingly complex health care system and can begin to address the fragmented nature of how care is paid for. The study documents that the likelihood of receiving medicine, doctors' care, or other treatment for these conditions differs greatly, depending on insurance status. Over the long term, risk identification will allow payers and providers to also begin to target low-risk groups in order to prevent decline and decrease the number of people who progress to chronic illness and disability. No clients were mentioned in this issue.