How employers can improve chronic condition management

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.¹

• 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 2020⁵
• Colonoscopies
  • were down almost 90% in April 2020⁶

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.⁷,⁸

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-19.⁹ 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.¹⁰ 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.¹¹ The need is there, but organizational leaders may not know how to support employees with chronic health conditions.

Here are some suggestions:

• 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.
• 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).
• 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.
• 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.¹²

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

• Transform Diabetes Care – personalized, comprehensive diabetes management program
• Pharmacist Panel – specially trained pharmacists providing proactive, ongoing support for highest-risk members to help better manage overall conditions

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. 

We combine physical, digital and virtual solutions to help people more successfully manage their chronic health conditions.

The source for data in this document is CVS Health Enterprise Analytics, unless otherwise noted.

CVS Health uses and shares data as allowed by applicable law, and by our agreements and our information firewall.

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