Sat. Nov 28th, 2020

You a African-American Women – College educated, middle aged and slightly overweight. Your Knee arthritis Getting worse and you have a decision to do: should you muddy through painkillers, gradually become less and less active, or consider treatments such as joint replacement? If you can know in advance about the costs of delaying treatment – your future wages, the physical effects of immobility, and the quality of life – that can inform your decision.

In Monday’s session, “Case Study: Patient Engagement is Key to the Success of a Value-Based Health Care System,” part of the third annual US News Hospital of Tomorrow Forum, Medical and health-disparity experts explain why enabling such decisions is important for patients, health care systems, and the nation. Zimmer Biomet, Inc. President and CEO of David Dvorak moderated the session.

His challenge: meeting the needs of an increasingly diverse group of patients. These patients may have previously lacked access to the health care system and now enter with high levels of chronic conditions such as obesity, diabetes, heart disease, and arthritis.

Their focus: reducing the cost of health care related to musculoskeletal conditions and the disproportionate burden of personal disability.

Their pilot scheme: Use of the knee arthritis cost model to engage patients in healthy behavior. Giving patients a glimpse into their futures – in terms of returns to life, quality of life, healthcare expenses and lost salary – can help influence their medical treatment and lifestyle choices. This framework aims to promote shared decision making and maximize value-based health care.

“No treatment costs us – it’s the most expensive option,” said panelist Dr. Yale School of Medicine and director of the Musculoskeletal Center at Yale-New Haven Hospital. Mary O’Connor said. “Inequalities are real and cost [fall onto] Three stakeholders: patients, employers and the health system. “

The cost of US health and health care disparities reached $ 1.2 trillion over a four-year period by panelist Darrell Gaskin, an associate professor of health economics and deputy director of the Center for Health Inequality Solutions at the Bloomberg School of Public Health in Johns . Hopkins University.

O’Connor described joint pain, limited mobility, lack of physical activity, obesity, increased pressure on knee joints and the “vicious cycle” of joint pain. Heart disease, type 2 diabetes and depression are more likely to follow. These related conditions can be risky for treatment providers and possibly discourage necessary interventions. For several reasons, African-American and Hispanic women face higher lifetime costs than white women with knee arthritis, O’Connor said.

One video featured focus-group patients in Baltimore who described the effects of arthritis on their activity levels and work life, such as forcing a woman to decline career opportunities that led to her financial The future will improve, as knee-related pain and immobility prevented him. To execute a task.

Using patient-engagement tools and cost models, providers were able to show directly between potential scenarios the positive impact treatment would likely have on patients’ future ability to drive, work, and remain independent.

The new value-model tool allows health providers to plug in mixed factors, such as age, weight, gender, education, race / ethnicity, and coexistence conditions. Doctors and nurse practitioners can show patients that different treatment courses are likely to affect the cost of their health care, the future of work, and the quality of life – in one year, five years, and even 20 years.

This personal model engages patients in an innovative way, O’Connor said. And when patients buy for a healthier approach, he said, everyone benefits, including employers and the health care system. Gaskin noted that patients’ treatment adherence, once agreed, will be addressed in the next pilot phase.

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