How Employers Can Improve Chronic Condition Management

Health care costs are expected to rise next year as plan members face long-term effects of COVID-19

BRIEFING
November 30, 2021
Vice President & Chief Clinical Innovation Officer, CVS Caremark

Chronic care management is a complex and important priority for payors and plan members. Chronic conditions, when left unchecked and unmanaged – whether for weeks, months, or years – can result in serious illness, hospitalization and death. The financial impact should come as no surprise: Chronic illness, such as heart disease, cancer and diabetes, drives 86 percent of health care costs.The Relation of the Chronic Disease Epidemic to the Health Care Crisis (nih.gov)

6 in 10
U.S. adults have a chronic diseaseAbout chronic diseases. (2021, April 28). Retrieved September 09, 2021, from https://www.cdc.gov/chronicdisease/about/index.htm
7 of 10
top causes of death in the U.S. are chronic diseasesWorkplace health promotion. (2020, March 10). Retrieved September 09, 2021, from https://www.cdc.gov/chronicdisease/resources/publications/factsheets/workplace-health.htm
$36.4B/year
cost for U.S. employers resulting from employee missed days of workCOVID-19 and Chronic disease: The impact now and in the future. (2021, June 17). Retrieved September 09, 2021, from https://www.cdc.gov/pcd/issues/2021/21_0086.htm
6 in 10
U.S. adults have a chronic disease2
7 of 10
top causes of death in the U.S. are chronic diseases3
$36.4B/year
cost for U.S. employers resulting from employee missed days of work4

The COVID-19 pandemic created new challenges for people with chronic disease

Mammograms and pap smears

were down nearly 80% from April 2019 to April 2020The Impact of COVID-19 on the Use of Preventive Health Care - HCCI (healthcostinstitute.org)

Colonoscopies

were down almost 90% in April 2020 The Impact of COVID-19 on the Use of Preventive Health Care - HCCI (healthcostinstitute.org)

Many people with chronic conditions deferred or delayed care due to fear of contracting COVID-19 in health care settings. Meanwhile, lockdowns and stay-at-home orders across the United States further limited access to in-person medical care. As a result, studies show significant decreases in cancer screenings, biopsies and surgery during the pandemic, along with drops in preventive services, routine monitoring and treatment of diabetes and hypertension. Impact of COVID-19 on Cancer Care: How the Pandemic Is Delaying Cancer Diagnosis and Treatment for American Seniors | JCO Clinical Cancer Informatics (ascopubs.org)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7359916/

Mammograms and pap smears

were down nearly 80% from April 2019 to April 20207

Colonoscopies

were down almost 90% in April 20208

We’re also seeing people experience long-term COVID-19 effects, including heart problems and breathing issues. Caring for patients with lingering COVID-19 signs and symptoms poses another challenge for the U.S. health system already dealing with the growing burden of chronic disease.

The pandemic’s long tail may increase utilization and health care spending for chronic conditions in 2022. We’re expecting chronic disease needs to rise because of the long-term effects of COVID-19. Business Group on Health’s 2022 Large Employers’ Health Care Strategy and Plan Design Population health deteriorated during the pandemic, with increased alcohol and tobacco consumption, poor nutrition and reduced physical activity. These behavior changes could have long-term negative effects on health, especially for individuals with chronic conditions.

While health care spending in 2020 was lower than expected due to disruptions in routine and nonemergency care at the onset of the pandemic, it’s likely to trend upward in the next year.https://www.pwc.com/us/en/industries/health-industries/library/behind-the-numbers.html The resumption of pandemic-deferred care is a good thing: It’s crucial that people with or at risk for chronic conditions return for treatment or preventive services and get back into healthy habits. Getting regular care back on track will help people better manage their chronic conditions and improve outcomes, while lowering overall health care costs.

Employers are well positioned to help fight chronic disease today and moving forward

In a survey of more than 1,000 U.S. workers, 60 percent say their leaders are unprepared to support employees with a serious and/or chronic medical condition.2019 Workplace Survey | Cancer and Careers The need is there, but organizational leaders may not know how to support employees with chronic health conditions.

Here are some suggestions:

Checkmark Formal policies and informal arrangements. Codify policies and programs that address the needs of workers affected by chronic conditions, enabling alterative worksite arrangements and flexible work options.
Checkmark Culture. Build a culture of health in the workplace, emphasizing the importance of managing stress and mindfulness, stretching and moving throughout the day and encouraging good nutrition (at the cafeteria and at company events).
Checkmark Flexible work arrangements. Remote work became the reality for many during the COVID-19 pandemic, and ongoing telework accommodations can offer people a way to manage their chronic conditions and careers.
Checkmark Supportive programs. Employers should not only make workplace programs available but also elevate their visibility to get more people involved.

CVS Health’s omni-channel approach can help employers and employees better manage and even prevent chronic conditions

Care for chronic conditions can be complex, confusing and inconvenient. It involves prescribed medications, lifestyle changes, screenings, and testing and monitoring of specific factors such as blood glucose and blood pressure. This is especially challenging because most people only visit the doctor four times a year, for less than 15 minutes.https://www.commonwealthfund.org/publications/issue-briefs/2020/jan/us-health-care-global-perspective-2019

That’s why increased support and connections are key to fighting chronic disease. And at CVS Health, we’ve built a model that helps close gaps between regular doctors’ visits through local community resources and virtual capabilities. By expanding and enhancing the ways people can engage with CVS pharmacists, MinuteClinic clinicians, or CVS HealthHUBs, our care management and condition management programs provide support that is convenient, caring and connected.

Clinical Product Initiatives
Checkmark

Transform Diabetes Care – personalized, comprehensive diabetes management program

Checkmark

Pharmacist Panel – specially trained pharmacists providing proactive, ongoing support for highest-risk members to help better manage overall conditions

We offer health plans flexible cost-control and quality improvement strategies through:
Checkmark

Full guideline alignment: The ability to adopt clinical pathways that offer a comprehensive range of treatment options.

Checkmark

Support at each treatment stage: Frequent touchpoints and data sharing to help keep patients on appropriate therapies with greater adherence and earlier identification of adverse events. This support helps drive better patient experience as well as cost savings.

While there are still challenges ahead, silver linings have emerged from this public health crisis: First, the pandemic has shed light on the implications of chronic conditions on overall health. Second, we’ve seen more openness around innovation and a willingness to embrace new technology, tools and capabilities. Let’s continue to bridge the gap between addressing chronic conditions and improving health and wellness. 

Want to learn how chronic disease management can lower costs and improve outcomes? Ask Us
BRIEFING
November 30, 2021
Vice President & Chief Clinical Innovation Officer, CVS Caremark

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