Chronic Disease

Understanding Chronic Kidney Disease Coverage, VBC Opportunities

November 22, 2023 - Efforts to improve chronic kidney disease coverage have evolved over the last several decades, but the disease remains costly and prevalent. Around 15 percent of the adult population in the US has chronic kidney disease (CKD), according to the National Kidney Foundation (NKF). The condition is one of two that, in its final stages, can make individuals eligible for Medicare regardless...

Read More


More Articles

How Much Members Spend on Diabetes Chronic Disease Management

by Kelsey Waddill

Members with diabetes spend between $3,300 and $4,600 per year in out-of-pocket costs for chronic disease management, including lost wages, according to a new report from GoodRx Health. These...

Avoidable Hospitalizations Less Common in Medicare Advantage, Study Finds

by Victoria Bailey

Medicare Advantage beneficiaries were less likely to have avoidable hospitalizations than those in traditional Medicare, suggesting that the use of provider networks in Medicare Advantage may reduce...

4 Essential Components of Chronic Disease Management Strategies

by Kelsey Waddill

With the US spending $3.7 trillion on diseases like diabetes, cancer, and other long-term conditions each year, payers cannot afford to falter on chronic disease management. Chronic disease spending and prevalence trends are stark, but...

5 Chronic Diseases Plague High Spending Group Health Plan Members

by Kelsey Waddill

Group health insurance plan members with high healthcare spending often have one or more of the same five chronic diseases, according to a fast facts sheet from the EBRI Center for Research on Health...

Medicare Advantage Risk Adjustment Model Accuracy May Vary By Race

by Kelsey Waddill

The CMS-Hierarchical Condition Category (HCC) model used for Medicare Advantage risk adjustment may inaccurately estimate beneficiaries’ spending depending on the race or ethnicity of the...

Type 2 Diabetes Patients Benefit from Capital Blue Cross Program

by Mark Melchionna

After engaging in a free program provided by Capital Blue Cross (Capital), type 2 diabetes patients experienced a variety of health improvements along with noticeable financial benefits, according to a...

4 Categories of Preventive Care Services Covered Under the ACA

by Kelsey Waddill

There are four types of services that private payers and employers are required to cover under the Affordable Care Act (ACA) preventive care services provision, which include screenings and...

Long-Term COVID-19 Symptoms Associated with Higher Unmet Needs

by Kelsey Waddill

Patients with a post–COVID-19 condition (PCC) faced higher unmet needs due to affordability and access to care barriers, a study published in JAMA Network Open found. Data for this study came...

Aetna Offers Virtual Care Tool for Gastrointestinal Chronic Diseases

by Kelsey Waddill

Aetna launched a partnership with a virtual care company to provide chronic disease management for members with digestive issues. Aetna’s partner offers a virtual care platform dedicated to...

The Cost of Cancer Should Reflect Impacts on Wellbeing, Productivity

by Kelsey Waddill

The cost of cancer goes beyond financial expenditures for adolescent and young adult patients, extending into mental health impacts and workplace productivity losses, according to a report...

Medicare Advantage Beneficiaries Have Better Diabetes Patient Outcomes

by Kelsey Waddill

Medicare Advantage plans have seen better patient outcomes in chronic disease management for diabetes than fee-for-service Medicare, according to a study by Avalere. “Medicare Advantage is...

Payer Announces Partnership to Offer In-Home Care with Flexible Hours

by Kelsey Waddill

Blue Shield of California (Blue Shield) has partnered with an in-home care organization to help members recover from injuries and illnesses. The goal was to make care more accessible and convenient...

Elevance Health Will Acquire Specialty Pharmacy To Treat Chronic Diseases

by Kelsey Waddill

Elevance Health has announced plans to acquire a comprehensive specialty pharmacy for patients with complex and chronic diseases. “As a trusted, lifetime health partner, the acquisition of...

Dialysis Triples Healthcare Spending for Members with Chronic Diseases

by Kelsey Waddill

Dialysis increased monthly spending for privately-covered members with chronic diseases by approximately 292 percent, according to a study published in JAMA Open Network. The researchers drew their...

UHC Awards $200K in Social Determinants of Health Grants in NM

by Kelsey Waddill

UnitedHealthcare is offering four grants to community organizations that are addressing social determinants of health in New Mexico, UnitedHealth Group announced. “Healthy living goes beyond the...

Uninsurance, Medicaid Coverage Could Delay Colon Cancer Diagnosis

by Kelsey Waddill

Health insurance type is a risk factor for delayed diagnosis of colon cancer, according to a research letter published in JAMA Network Open. The researchers noted that less than four out of ten...

Emergency Department Patients Are More Likely to Have Chronic Diseases

by Kelsey Waddill

Chronic diseases are common among emergency department patients, particularly among seniors and those ages 45 to 64, according to a National Health Statistics Report. “Monitoring ED visits made...

Hepatitis C Treatment Rates Reveal Care Disparities in Public, Private Coverage

by Kelsey Waddill

Treatment initiation rates for hepatitis C indicate care disparities for individuals who are not White as well as those who are younger and male individuals, a report from the Centers for Disease...

Medicaid Health Home Benefit Covers Children with Complex Conditions

by Kelsey Waddill

CMS has issued guidance for state Medicaid programs about how to use the Medicaid health home benefit to support children with complex medical conditions. “This new state plan option is about...

Recent Articles