Chronic Disease Management

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...


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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...

3 Ways That Large Employers Influence Health Insurance Costs, Coverage

by Kelsey Waddill

Traditionally, health insurance companies have been the face of the payer industry, for better or for worse. But companies have incredible sway in the health insurance world, particularly large employers. Employers offer and manage...

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...

Healthcare Spending Lower in MA for Beneficiaries with Chronic Conditions

by Victoria Bailey

Medicare Advantage beneficiaries with chronic conditions had lower healthcare spending and fewer emergency room visits than fee-for-service (FFS) beneficiaries, according to a report from Avalere...

Beneficiaries’ Chronic Conditions Did Not Drive MA to FFS Switching Rates

by Victoria Bailey

Beneficiaries with multiple chronic conditions did not have higher rates of switching between Medicare Advantage and Medicare fee-for-service (FFS), according to a study published in JAMA. As Medicare...

How to Personalize Chronic Disease Management through Concierge Care

by Kelsey Waddill

Updated 6/21/2023: This article has been updated to correct a name and title error. The interviewee's name and title have been corrected to "Anthony Nguyen, chief clinical officer at Elevance Health." A previous version...

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...

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...

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...

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...

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...

Healthcare Utilization Lower for MA Beneficiaries with Complex Care Needs

by Victoria Bailey

Among Medicare beneficiaries with complex care needs, those enrolled in Medicare Advantage had lower acute healthcare utilization than traditional Medicare beneficiaries, including lower rates of...

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...

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...

UnitedHealthcare Cuts Out-of-Pocket Healthcare Costs for Insulin

by Victoria Bailey

UnitedHealthcare has announced that it will eliminate out-of-pocket healthcare costs for insulin and other emergency use drugs for fully insured group health plan members. Members will be able to...