House Approves Baker Plan for Chronic Disease Management Program

[NRSKarenRN, BSN, RN]

Many say chronically ill patients would have better, more cost-effective treatment

HARRISBURG - The House this week approved legislation sponsored by Rep. Matt Baker (R-Tioga/Bradford) that would create an innovative program to cost-effectively coordinate treatment and teach chronically ill patients how to become more involved in their health care. "Chronic diseases have reached epidemic levels throughout the country, including Pennsylvania," Baker said. "Approximately one in 10 Americans suffers from a chronic disease, accounting for 90 percent of overall health care expenditures. In fact, we now have the dubious honor of ranking fifth among the 50 states in the number of adults diagnosed with diabetes.

"Treatment for this disease, as well as for asthma, congestive heart failure and high risk pregnancies, very often involves several physicians and other medical providers. This can lead to duplicative and sometimes unnecessary services - including emergency room visits and hospital stays," Baker said.

The end result can be less than effective treatment at higher costs, particularly for those patients receiving medical assistance. The Wellsboro lawmaker said that with the Commonwealth operating the sixth largest medical assistance program in the nation, covering approximately 1.7 million individuals, this means a great many patients suffering from chronic illnesses are slipping through the cracks.

"As a better way to ensure availability of high-quality, cost-effective health care, my legislation (House Bill 2500) creates a Comprehensive Disease Management Program within the Department of Public Welfare (DPW)," Baker said.

Such a coordinated program helps provide the chronically ill with access to the latest advances in treatment and teaches them how to be active participants in their health care through health education.

By aggressively treating these patients through primary care management, they will live healthier lives and reduce the need for more costly treatments.

Twenty-one other states have already implemented similar programs which are improving the lives of chronically ill patients while also reducing costs of care.

House Bill 2500 specifically authorizes DPW to administer the Chronic Disease Management Program for medical assistance fee-for-service program recipients.

The department could contract for the development of the program to provide services to medical assistance recipients suffering from certain ailments and diseases, including diabetes, asthma, congestive heart failure and high risk pregnancies.

In addition, DPW would be required to seek any waivers necessary from the Centers for Medicare and Medicaid Services.