The proposed project deals with the issue of chronic disease management and strategies for approaching the problem that Anthem as an insurer can implement. The argument is that nearly a half of the United State’s population has at least one chronic condition and this element of care provision is the most costly, which affects the profitability of insurance companies (Raghupathi & Raghupathi, 2018).
Key performance indicators, in this case, are connected to the number of patients that are admitted to a hospital due to their chronic condition if the case could be managed at home and number of individuals using the project’s intervention. Kyte et al. (2015) recommend using patient-reported performance measurement. Outcome measures include the improvement of quality of life in individuals with chronic conditions that use the proposed intervention.
The recent literature on the topic provides substantial evidence for a need for applying better management practices to ensure that the number of hospital visits and quality of life are satisfactory. The APHA (2019) argues that despite the advances in medicine that have prolonged the number of years lived by an average American, issues such as diabetes, cancer, or chronic heart conditions severe impair the quality of life. However, the possibility of prevention is one distinct feature that distinguishes these diseases from acute conditions.
Hamine, Gerth-Guyette, Faulx, Green, and Ginsburg (2015) argue that mAdherence programs, initiatives that use mobile technologic devices can significantly improve the success of chronic disease management. The authors examined 107 randomized controlled trials to identify the potential of innovative technology in improving patient’s health. Thus, mobile health – a novel strategy in healthcare can significantly enhance the adherence of patients to the required lifestyle and medication interventions used in chronic condition management.
In general, a large number of factors impacts the reimbursements associated with chronic diseases. Raghupathi and Raghupathi (2018) state that identifying the correlation between a specific chronic condition, amount of hospitalizations, and behavioral factors is crucial for developing a successful intervention. This is an increasing concern because of the ongoing aging of the population in the US, leading to an increased burden of chronic disease management for healthcare organizations such as Anthem. This evidence supports the claim that chronic conditions will become a significant healthcare concern in the next several years.
The value of the proposed project to Anthem is in the ability to reduce costs associated with the unnecessary hospitalization of patients with chronic conditions. Waidmann, Ormond, and Bovbjerg (2011) argue that chronic diseases can be either prevented or successfully managed at home without a need to frequently visit hospitals, which will decrease the number of reimbursement payments Anthem has to provide to medical establishments. In terms of professional career, it will help me understand the process of developing an evidence-based intervention that will target both the improvement of life for patients and enhance the bottom line of my company using innovation.
In essence, a value proposition is to develop a strategy that uses modern day technology allowing patients with chronic conditions that use Anthem’s services to track their health and thus eliminating the need for frequent hospital visits. The strategic, systems perspective requires one to consider all aspects of chronic condition management and both inconveniences and financial losses that are caused by inadequate management strategies. According to Anthem’s mission, vision, and value statements, they deliver value to patients by incorporating innovation and best practices of care, which is consistent with this proposal (“Mission, vision and values,” n.d.).
A process map can be used to visually display data summary for the insurance company over one year. Overall, this proposal introduces the problem of chronic condition management, its implications for Anthem, and literature relevant to this topic.
APHA. (2019). Chronic disease. Web.
Hamine, S., Gerth-Guyette, E., Faulx, D., Green, B., & Ginsburg, A. (2015). Impact of mHealth chronic disease management on treatment adherence and patient outcomes: A systematic review. Journal of Medical Internet Research, 17(2), e52. Web.
Kyte, D., Calvert, M., van der Wees, P., ten Hove, R., Tolan, S., & Hill, J. (2015). An introduction to patient-reported outcome measures (PROMs) in physiotherapy. Physiotherapy, 101(2), 119-125. Web.
Mission, vision and values. (n.d.). Web.
Raghupathi, W., & Raghupathi, V. (2018). An empirical study of chronic diseases in the United States: A visual analytics approach to public health. International Journal of Environmental Research and Public Health, 15(3), 431. Web.
Waidmann, T., Ormond, B., & Bovbjerg, R. (2011). The role of prevention in bending the cost curve. Web.