Organizations Start Focusing on Chronic Disease Management

By Peter T. Kilborn N. Y. Times News Service | THE JOURNAL RECORD, January 13, 1999 | Go to article overview
Save to active project

Organizations Start Focusing on Chronic Disease Management


Peter T. Kilborn N. Y. Times News Service, THE JOURNAL RECORD


WEST CHESTER, Pa. -- Nick Polidore, a state gymnastics champion with bangs, dimples and baggy blue jeans, would seem as robust as any other 11-year-old. But he has asthma, so ragweed or a simple cold can propel him to an emergency room, gasping for breath.

Once, an asthma attack would keep him in a hospital for a day or two. But since his family doctor, Brandt S. Loev, took up disease management, a system for controlling chronic conditions like asthma, the big emergencies have stopped -- and so have the big bills to his mother's health insurance company.

Disease management sounds familiar, even common-sensical. On each office visit, Loev checks Nick's breathing and health completely and then an aide teaches him how to avoid attacks, how to use inhalers, how to test his lungs himself with a simple bedside device the clinic gave him. Once upon a time, this is what managed care was supposed to do: cut costs by keeping people healthy. Instead, health management organizations and insurance companies concentrated on cutting costs, especially by reducing doctors' fees. But now that those methods have played out and in many cases profits evaporated, some health care organizations are looking to better medical practice as an answer. The new remedy is managing chronic diseases, which account for 60 percent of medical costs in the United States. "The next phase has to be managing care better and disease management is another word for that," said Uwe S. Reinhardt, a health care economist at Princeton University. The movement is breeding as many as 300 companies that contract with health maintenance organizations and employers to supervise the care of people with chronic diseases. The revenue of these companies is expected to double over the next year, to $348 million, said Al Lewis, a broker who negotiates contracts for the companies with health maintenance organizations. Among the 1,000 HMOs that belong to the American Association of Health Plans, at least 150 are collaborating with the American Diabetes Association in a 10-year disease management program that aims to reduce blindness and foot amputations among diabetics by 40 percent and kidney failure by 30 percent. One leader in the movement is the University of Pennsylvania Health Center, which offers management programs for 20 chronic conditions through its 85 clinics in and around Philadelphia, including Loev's clinic in West Chester. In September, it licensed VHA, a group of more than 1,200 nonprofit hospitals, including Columbia Presbyterian in New York, to use its programs. "Everybody's talking about it," said Dr. Joseph Carver, disease management medical director for Aetna U.S. Healthcare, which has enrolled nearly 59,000 members in programs that include those for managing congestive heart failure and low back pain. "Everybody says they're doing it." But disease management is still a small part of health care, and it is not clear whether it will gain wide acceptance among doctors, some of whom belittle it as "cookbook medicine.

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
Loading One moment ...
Project items
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited article

Organizations Start Focusing on Chronic Disease Management
Settings

Settings

Typeface
Text size Smaller Larger
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

While we understand printed pages are helpful to our users, this limitation is necessary to help protect our publishers' copyrighted material and prevent its unlawful distribution. We are sorry for any inconvenience.
Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.

Are you sure you want to delete this highlight?