SD4 - Final Report: Opportunities for Early Identification and Preventive Care for Chronic Diseases [SJR 325 (2009)]

Executive Summary:

Senate Joint Resolution 325, introduced by Senator Houck in 2009, directed the Joint Commission on Health Care (JCHC) to:

“(i) examine clinical and other studies concerning the manner in which early identification and preventive care can be utilized to halt or slow the evolution of such conditions as diabetes, hypertension, kidney disease, obesity, and pneumonia into chronic and terminal conditions;

(ii) assess the means by which Virginia can address fragmentation of services across the health delivery system and the patient’s community in order to enhance early identification and preventive care and care management for chronic disease, and to identify opportunities for providing more coordinated care management for individuals with multiple chronic diseases; and

(iii) estimate the fiscal impact on the Commonwealth and private payers from such strategies."

Chronic diseases (such as heart disease, diabetes, asthma, chronic obstructive pulmonary disease, and kidney disease) are a leading cause of adult disability and account for 70 percent of all deaths in the United States. In addition, chronic diseases accounted for more than 75 percent of the nation’s $2 trillion in recent health care expenditures. Chronic disease expenses are typically driven by reoccurring acute care events such as emergency room (ER) visits and hospitalizations or costly inpatient and outpatient treatment plans. Individuals with chronic conditions typically have multiple health care providers, treatment plans, and prescriptions written by different physicians often with no coordination of the medical care.

There is a spectrum of potential approaches the Commonwealth could take to address chronic disease and the fragmentation of the health care system. This spectrum ranges from disease management programs which base care coordination around the identification of specific diseases to programs that focus on all of the person’s needs and the available service delivery systems to address those needs.

Based on the study findings, JCHC members voted to make two requests by letter of the Chairman. First, a request that the Department of Medical Assistance Services report to JCHC regarding recommended options for addressing the chronic care needs of Virginia’s Medicaid and FAMIS enrollees. Second, a request that the Department of Human Resource Management report to JCHC regarding the costs and benefits of the recently implemented COVA Connect pilot program for State employees.