Top Five Common Health Concerns
In our last post, Better Care Management: A Performance Review, we presented summaries of our recent work with two major large-group clients. The piece showed big returns (as much as 5 to 1) from effective condition management and the hard work required to help individuals improve their lives.
In today’s post and two more that will follow, we asked Curally Chief Medical Officer Ernie Vesta, MD, to identify the common concerns and cost drivers we see in health plan participants, as well as our most frequent responses as we begin working with individuals.
Why spend time on these topics? Because sharing our insights may help you, our reader, recognize more fully what is happening with your own health benefit plan. And, of course, we would also like you to better understand how Curally works to improve health and lower healthcare costs.
Curally obtained the insights presented here not by just looking at healthcare claims data. Instead, we are drawing this information from a broader set of data, including our actual, personal experience with individual health plan participants.
Caution: These lists may surprise you! Each encounter we have with a participant involves more than the presenting medical conditions and a diagnosis. After all, individuals are more than data points and labels that can be captured on a medical claim. Instead, they are complex human beings, and that makes each case more challenging—and progress more rewarding.
Keep in mind that Curally does not replace the plan participants’ physicians or other healthcare providers. Curally’s Chief Medical Officer and nurses work with the plan participants and their providers to produce improved health, lower healthcare costs and better quality of life.
Top Five Most Common Concerns Encountered by Health Plan Participants
with Diagnosed Health Problems
- Diabetes and diabetes-related issues are, by far, the most common health problem affecting health plan participants. This may not be surprising, as 34 million people in the US are afflicted with Type II diabetes alone. For comparison, the potential negative impact of diabetes on the patient and health benefit plan is three times that of other common diseases—high blood pressure, respiratory failure, certain gastrointestinal problems and cardiac diseases. Put another way, the potential benefit of identifying, treating and managing diabetes is potentially three times as great as responding to the other illnesses.
- Questions participants have about their health conditions and care. Big surprise here, perhaps. Not another medical disease, but a real source of struggle for health plan participants. Even after visiting with their medical professional, participants face questions. Especially after the participants return home from the physician visit, the little questions germinate and grow into bigger questions that trouble the mind and raise anxiety, cause sleeplessness. How can the participant handle this? The more participants have someone to turn to—an easily accessible resource, someone to reach out to—the more this concern is mitigated.
- A new diagnosis. Related to #2 above, this concern is proportional to the participant’s ability to access someone who can provide clarification, listen to their concerns and share information. The participant receiving the diagnosis has limited capacity to process the information initially given, fully, quickly. Yet their need for more or better information is great. This need requires attention.
- Options sufficiency. Participants are confounded by the options present—often too few, often too many to discern and prioritize. Which one is best for me? Is there no other to consider? The resulting confusion and anxiety is a drain on the participant, sometimes leading to withdrawal or poor decision making.
- The necessity equation. When it comes to treatment and therapeutic recommendations, at some point, participants will question the necessity of the prescribed course of action. Why do I need this? Will it work? Why this and not an alternative? It is very personal for each individual.
For each of these concerns, personalized coaching and assistance from a compassionate professional can help the participant address their questions and navigate the healthcare system at every stage of the journey. Curally helps break down the complexities of the situation into smaller considerations and differences, particularly in large cases involving multiple specialists.