Nation's Economic Downturn Threatens Continuity of Care for Chronic Conditions

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DMAA Members Report Some Payers Scaling Back Chronic Disease Initiatives

WASHINGTON, D.C.—DMAA: The Care Continuum Alliance, responding to reports that many Americans are forgoing basic medical care in the economic downturn, today called for renewed vigilance in the fight against chronic disease and support for care management.

"While some forms of belt-tightening make sense in tough economic times—dining out less often or carpooling, for example—we can't afford to extend cost-cutting to medical care, especially for people with chronic conditions," DMAA President and CEO Tracey Moorhead says. "As the cost and prevalence of chronic diseases threaten to overrun our health care system, now is the time to increase our commitment to the chronically ill and those at risk, not cut back."

Recent surveys and reports paint a troubling picture of the response by many Americans to the nation's economic woes:

• Twenty-two percent of U.S. consumers have put off physician visits and 11 percent have delayed refilling prescriptions or taken smaller doses than prescribed, a National Association of Insurance Commissioners survey found.
• In a CIGNA survey, of those who said today's economy has caused them to change the way they take care of their health, 41 percent report taking worse care of themselves. Among these individuals, 35 percent are not going to the doctor regularly or at all and 17 percent are taking medications less often or not at all. Ten percent said they can't afford to eat properly or eat less healthful foods.
• The Rockefeller Foundation and Time magazine reported that 10 percent of respondents did not take a child to the doctor due to economic pressures.

Further, DMAA member organizations report that, as the economy weakens, some payers—including some state Medicaid programs—are pulling back from plans to institute population-based programs for the chronically ill, such as wellness and disease management initiatives.

"Any time you interrupt continuity of care, particularly for chronic disease, you risk slipping backward in health status and creating higher costs when conditions worsen for lack of regular care," Moorhead says. "Retreating now from these important programs might generate short-term savings. But ultimately, it will cost much more in health status and health care dollars."

Diabetes care offers one example of the wisdom of investing now in patient self-management programs, Moorhead says. "Studies consistently show better medication adherence, increased rates of A1C testing, more frequent retinal and foot exams, fewer hospitalizations and other improved health outcomes through these programs," she says. "They also show significant costs savings through reduced hospitalizations and emergency department visits—in some cases, particularly for employers and states, double their investment or more."

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About DMAA: The Care Continuum Alliance

DMAA: The Care Continuum Alliance convenes all stakeholders providing services along the care continuum toward the goal of population health improvement. These care continuum services include strategies such as health and wellness promotion, disease management, and care coordination. DMAA: The Care Continuum Alliance promotes the role of population health improvement in raising the quality of care, improving health outcomes and reducing preventable health care costs for individuals with chronic conditions and those at risk for developing chronic conditions. DMAA's activities in support of these efforts include advocacy, research and the promotion of best practices in care management.

DMAA: The Care Continuum Alliance represents more than 200 corporate and individual stakeholders—including wellness, disease and care management organizations, pharmaceutical manufacturers and benefit managers, health information technology innovators, biotechnology innovators, employers, physicians, nurses and other health care professionals, and researchers and academicians. Visit DMAA on the Web at www.dmaa.org.

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