Accountable Care through the Health Home

Accountable care is about partnering with providers and community members to identify and address the complex needs of people with chronic health conditions,  and to create a supportive, accessible, and cohesive environment of care.

The Health Home initiative is an innovative approach with the promise to helping patients access comprehensive care coordination, meet their physical, mental, and social needs.  However, their are significant challenges when trying to engage and serve these individuals.  


In a report released by the Center for Disease Control (CDC), August 2012.  It mentions that Chronic Diseases are the Leading Causes of Death and Disability in the U.S.

• 7 out of 10 deaths among Americans each year are from chronic diseases. Heart disease, cancer and stroke account for more than 50% of all deaths each year.
• In 2005, 133 million Americans – almost 1 out of every 2 adults – had at least one chronic illness.

• Obesity has become a major health concern. 1 in every 3 adults is obese and almost 1 in 5 youth between the ages of 6 and 19 is obese (BMI ≥ 95th percentile of the CDC growth chart).

• About one-fourth of people with chronic conditions have one or more daily activity limitations.

• Arthritis is the most common cause of disability, with nearly 19 million Americans reporting activity limitations.

• Diabetes continues to be the leading cause of kidney failure, nontraumatic lower-extremity amputations, and blindness among adults, aged 20-74.

• Excessive alcohol consumption is the third leading preventable cause of death in the U.S., behind diet and physical activity and tobacco. 

Health home providers are charged with engaging and enrolling medicaid/manage care plan participants into the program.  But there are a few things that health home providers should considerate the early stages of the program.

• A supportive staff structure to meet the program needs such as outreach activities and follow up.
• A well defined enrollment process (responsible staff and timeline).
• Keeping participants engaged with monthly or necessary care coordination.
• Upper management having a clear understanding of resources needed to serve this complex population.
• Realistic goals that can be achievable.
• The State having a good understanding of the resources that health home programs will need to invest to make this program a success.

The health home program has a lot of potential, we will see how this initiative evolves and changes with the unique needs that people with chronic diseases are faced with on a daily basis.

About the Author:

Helen Dao, BA, MHA

Dao Consulting Services, Inc.

A public Health Company Connecting Providers and Communities

Jersey City, New Jersey

Tel. (201) 448-2046

www.daoconsultingservices.com

____________________________________________

References:

1. Kung HC, Hoyert DL, Xu JQ, Murphy SL. Deaths: final data for 2005. National Vital Statistics Reports 2008;56(10). Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr56/nvsr56_10.pdf  [PDF-2.3MB]
2. Wu SY, Green A. Projection of chronic illness prevalence and cost inflation. Santa Monica, CA: RAND Health; 2000.
3. Ogden CL, Carroll MD, McDowell MA, Flegal KM. Obesity among adults in the United States—no change since 2003–2004. NCHS data brief no 1. Hyattsville, MD: National Center for Health Statistics; 2007. Available from:http://www.cdc.gov/nchs/data/databriefs/db01.pdf  [PDF-366KB]
4. Ogden CL, Carroll MD, Flegal KM. High body mass index for age among US children and adolescents, 2003–2006. JAMA 2008;299:2401–2405.
5. Anderson G. Chronic conditions: making the case for ongoing care. Baltimore, MD: John Hopkins University; 2004.
6. Centers for Disease Control and Prevention. Prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation—United States, 2003–2005. MMWR 2006;55:1089–1092. Available from:http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5540a2.htm
7. Centers for Disease Control and Prevention. National diabetes fact sheet, 2007. Atlanta, GA: U.S. Department of Health and Human Services; 2008. Available from: http://www.cdc.gov/Diabetes/pubs/factsheet07.htm
8. Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual causes of death in the United States, 2000. JAMA 2004;291(10):1238–1245.)