Today, a chronic care commission appointed by Gov. Rendell will issue its plan to transform how such care is delivered in Pennsylvania. The idea is similar to the one used at the health clinic where Gass is treated: Help patients manage their conditions before problems get out of control.
Under the plan, family doctors and other clinicians will be trained and get financial support to redesign their practices. They'll be encouraged to develop a more team-oriented system aimed at changing patient behaviors, from providing basic education to calling people who miss appointments for key tests.
Patient registries that electronically track the delivery of care and alert doctors to patient needs for treatments will be developed and provided free of charge to primary-care practitioners.
The multiyear rollout of the plan, developed by the Chronic Care Management, Reimbursement and Cost Reduction Commission, is expected to begin in May when 50 to 100 caregivers in the Philadelphia area gather for an intensive "learning collaborative" to teach them the new format.
Rendell hopes that over time people with chronic illnesses will become healthier, avoid hospitalizations, and live longer.
And that will save money, too.
Health-care costs will drop, Rendell says, freeing money to provide coverage to many of the state's 800,000 uninsured adults.
In Philadelphia and its Pennsylvania suburbs, potentially preventable complications of high blood pressure, asthma and diabetes led to nearly 23,000 hospital admissions in 2006 and generated bills of more than $1 billion.
Statewide chronic disease accounts for 80 percent of health-care costs and four out of five hospitalizations, according to the chronic care commission.
Under the plan, experienced "practice-coaches" will provide the first wave of doctors with ongoing technical assistance. Insurers will help pay for the new staff needed to move toward a more patient-centered system.
