Chronic diseases by definition are long-lasting. They are lingering conditions. Even so, they are frequently treated with episodic care rather than long-term disease management. Considering how prevalent chronic diseases have become in the United States and how much our nation spends treating people with chronic diseases, it makes sense to look at patient care and ask what more we could be doing to manage and prevent chronic conditions.
In addition, providers may find this series of blog posts valuable as they pursue managing chronic conditions and the populations they represent, and reporting their data to a healthcare registry.
Here is a brief look at Episodic vs. Holistic healthcare and how each approaches treatment and management of chronic diseases.
Traditional episodic care.
If you think about it, the purpose of traditional care is to eliminate symptoms when an ailment arises. If a patient is suffering from a sore throat and tests positive for strep, they usually can be given a prescription and cured of their painful condition, end of story. But that isn’t the case with chronic diseases - you can treat a patient’s symptoms but the disease isn’t gone. The symptoms will return and require treatment again and again unless you take action to address the cause and prevent them from returning.
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A preventative approach.
Because the Preventative Care Model is a more holistic approach that aims to minimize symptom flare-ups in the first place, it aligns well with chronic disease treatment. It works to address the cause of disease and continuously combat symptoms so patients can avoid emergency situations, ER visits, unnecessary medical expenses, pain and suffering. This approach to care treats chronic diseases for what they really are: ongoing conditions that need continuous management.
When you compare episodic and preventative care models it is easy to see that preventive care is a better match for chronic disease patients.
It's also easy to imagine that the shift from episodic care to preventive care and population health initiatives has gotten lost in the shuffle from fee-for-service to value-based care, but that focus is now sharpening again. New payment structures conceived as part of the Affordable Care Act are prompting hospitals to shift away from treating patients on a case-by-case basis to instead adopt a population health model focusing on chronic conditions such as diabetes and obesity. Indeed, value-based payment models have pushed hospitals more toward a preventative care, population health-based model. It also means hospitals are rethinking some of their community benefits as well, offering services that complement the new care model, such as addressing the social determinants of health - food, housing, and access to services - and the reduction of smoking and drug abuse.