While Lao Tzu, the founder of Taoism, could not have imagined the intricacies and complications involved with managing cardiovascular healthcare programs when writing "The Book of the Way" in the Sixth Century B.C., his simplistic, preventive methodology still could apply today, if approached early and systematically.
Last week, the American Heart Association (AHA) held its annual Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke Conference. Research presented at this meeting examines patient care, with an eye toward performance measures and whether adopting better systems of care could have widespread impact on healthcare costs and clinical outcomes.
At this meeting, Dr. Michael H. Kim from Northwestern University presented two studies, which assessed the current burden of managed care costs associated with treating patients with atrial fibrillation. Kim told Cardiovascular Business News that something needs to be done to reverse the current financial trends in treating this ever-increasing patient population, in particular to reduce their hospitalization and readmission rates.
In one study, Kim and his colleagues discovered that many a-fib Medicare patients aged 65 years or older fell into the ‘donut hole,' which means they had to pay for their meds. Kim cautioned that these medication expenses could lead some patients to discontinue medical therapy, resulting in sicker patients and more hospitalizations. This finding is particularly disconcerting, as the Archive of Medicine released a study this week, indicating that high co-pays are a deterrent for chronically ill patients to take their prescribed medications.
Developing individualized treatment plans, established by their cardiologist, could benefit a-fib patients tremendously, as the condition varies greatly, and might provide a simple, preventive method of initially treating this at-risk population.
Industry is making similar strides to preventively manage at-risk patients. Merck and payor Cigna inked a deal to discount Merck's blockbuster diabetes drugs to members who improve medication adherence.
As Tzu suggests, the least difficult patient to manage is the least sick, and only through preventive methods will the burden of cardiovascular disease cease to wreak such devastating havoc on the U.S. healthcare system.
On these topics, or any others, feel free to contact me.
Justine Cadet, News Editor