Right Care, Right Time, Right Level: With Evidence
As the Chief Medical Officer for Highmark Inc. and having been on the health insurance side of medicine since 2008 while actively practicing rural family medicine in Kentucky, I have seen the effect chronic diseases can have on healthcare delivery. From a patient perspective, pain and reduced ability to ambulate cause a reduced quality of life (QOL), which is never acceptable. From a provider perspective, the ability to effectuate a change on many chronic diseases is limited at best. From both a payer and society’s perspectives, the effect of chronic disease is profound. Its effects are felt economically from days of lost work, and treatment costs of medication and interventions. I will focus this discussion on osteoarthritis (OA) from a payer’s perspective. Patients with OA often require frequent medical attention with medication, diagnostic tests such as radiographs, physical therapy, pain management, and, less frequently, surgical intervention. The direct medical costs associated wi