Chronic Disease Management

The chronic disease management market encompasses consumers with chronic, complex conditions such as chronic kidney disease, diabetes, and heart disease. The challenges faced in this market are often compounded by the need for social services and supports. For provider organizations and health systems managing consumers with chronic conditions, a significant challenge that remains is addressing the rising cost of care for this population. As a result, payers are focusing on reducing the spend by increasing integrated models of care coordination across medical, behavioural, pharmacy, and social support systems. These new market forces are creating strategic opportunities for provider organizations that are serving this population.

Latest Resources

• Federal Government Awards $98 Million For Hepatitis C Elimination Initiative Pilot Services Contracts
• Medicare Chronic Care Management Model To Test Technology-Supported Care Plus Outcomes-Aligned Payments
• Almost 10% Of U.S. Adults Report Having Had Cancer
• FDA Approves Otsuka’s ‘Anti-APRIL’ Therapy Targeting A Type Of Kidney Disease
• Risk For Hearing Loss Significantly Higher For Those With Type 2 Diabetes
• Digital Interventions Could Ease Emotional Distress Among Adults With Congenital Heart Disease
• Hospitals Offering Digital Remote Patient Monitoring Services Up 40% In Five Years
• Epilepsy Incidence Among Older U.S. Medicare Population Saw 10-Fold Regional Variation In 2019
• More Children With Autism Report Gastrointestinal Symptoms Vs. Typically Developing Children
• An Executive Perspective: How AI Is Shaping The Future Of Integrated Care
• Diabetes Prevention Outcomes Similar For People With Prediabetes Using AI-Powered Lifestyle Intervention Versus Human Coaching
• Survey: 12% Of Adults Take A GLP-1 Medication For Diabetes, Obesity, Other Condition
• Nebraska Section 1115 SUD Demonstration Waiver Amendment
• Medicare Finalizes Behavioral Health Integration Add-On Codes For Advanced Primary Care Management
• FDA Clears Magstim Magnetic Stimulation For Chronic Pain Treatment

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Medicaid Coverage For Co-Occurring Chronic Pain & Opioid Addiction Varies Widely By State

Co-occurring chronic pain and opioid use disorder (OUD) are associated with a high disease burden for the patient, requiring comprehensive treatment approaches, yet Medicaid benefit structures for evidence-based therapies vary substantially across states, a recent study stated.  As the largest payer for substance use disorder (SUD) treatment and mental health services, Medicaid plays a crucial role in determining treatment access, the study stated. Recent policy reforms have expanded coverage for residential treatment and medications for… Read

• Global Cases Of Chronic Kidney Disease More Than Doubled Between 1990 & 2023, Reaching 788 Million
• Medicare Diabetes Prevention Program To Offer On-Demand Access
• Veterans Experience Adverse Kidney & Cardiovascular Outcomes Across Three GLP1s Prescribed For Type 2 Diabetes
• Most Remote Monitoring Claims Are For Physiological Data
• Medicare To Implement The New Ambulatory Specialty Model For Beneficiaries With Heart Failure & Those With Low Back Pain

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