The majority of patients (91%) with a chronic health condition need more help managing their disease.

One in five patients feel anxious or frustrated dealing with their chronic disease. Nearly four out of ten patients with a chronic condition admit they are only somewhat knowledgeable about how to best manage their health. A majority of patients want additional support from their providers, and nine out of 10 of those who want help managing a chronic condition say assistance from their provider would make a difference in their overall state of health.

Those responses are from a survey of 502 patients conducted by West Corp. and released in February at HIMSS 2017 in Orlando, Fla.

These findings also signal a need for more patient engagement in chronic care, and point to opportunities for healthcare organizations and providers to achieve better clinical and financial outcomes.

The emotional burden of chronic disease is challenging enough for patients. But in addition to the fear, anxiety and frustration chronic patients feel, many also say they lack the knowledge and confidence necessary to successfully manage their health.

44% of patients surveyed are only somewhat confident, at best, they are effectively managing their condition, and over half (59%) of patients with a chronic illness believe they are not doing everything they should be doing to manage their condition. As a result, one in five (20%) chronic patients rate their ability to manage their condition as fair or poor at best.

A lot of patients simply do not have a good grasp on health metrics—meaning they either don’t know what their current health metrics are, or they do not know what they should be. 43% of patients are only somewhat confident they know their current numbers for things like blood pressure and cholesterol. What’s more, even when patients do know their numbers, it is not guaranteed that they understand what those numbers mean. To make sense of health metrics and chronic disease management, patients need support from their healthcare providers

One in five patients feel they need 24-hour disease management assistance. Traditionally, chronic care has been delivered during face-to-face doctor visits. However, this outdated approach to chronic care does not support patients when and where they need help. Providers can help patients do a better job of managing their health by supporting them not just during office visits, but also at home and in daily life – where patients desire more assistance, especially online.

According to the survey, at least 70% of patients with a chronic condition would like more resources or clarity on how to manage their disease. Close to a third of patients say a better understanding of how to change unhealthy behaviors (35%), a more individualized treatment plan (33%) or tips and tools for handling their condition (31%) would help them be more effective in their treatment.

Providers must seize engagement opportunities

There are many different ways providers can engage patients and support them between visits. As the West survey findings show, patients desire personalized and targeted communications and information, and they also want regular check-ins from providers. Three-quarters (75%) of chronic patients want their healthcare provider to contact them regularly and alert them if anything looks wrong (only 30% of patients report receiving regular check-ins to review their progress).

Web-enabled technology such as automated surveys allow providers to routinely monitor chronic patients, escalate cases where patients are at risk, and intervene before patients reach the point of needing acute care. According to the survey, there is untapped potential for using patient surveys. Just 5% percent of providers say they use survey check-ins that ask patients for feedback about treatment plans.

Biometric monitoring devices like heart rate monitors and blood pressure cuffs offer similar benefits as patient surveys. When asked to choose between a one-way and two-way monitoring device, more patients (53%) prefer a two-way device. These tools provide additional opportunities to engage and monitor patients at home, and could be leveraged more by providers.

CMS penalties and incentives

Potentially avoidable readmissions are costing hospitals $528 million in Medicare penalties for the 2017 fiscal year. Healthcare organizations know that reducing preventable readmissions is in their best interest financially, but many do not realize that they are missing opportunities to prevent readmissions by proactively engaging chronic patients.

In January 2015, the Centers for Medicare & Medicaid Services began reimbursing chronic care management (CCM) services for qualified Medicare beneficiaries who have at least two chronic conditions expected to last longer than a year. CPT code 99490 reimbursement varies from state to state, but generally CMS reimburses at approximately $42.60 per beneficiary (every month) to physicians for implementing processes to manage patients outside of the clinical setting.

With government incentivizing chronic care management, and patients demanding it, providers can more successfully manage chronic diseases by more effectively engaging and supporting chronic patients.

Fonda Narke is director of product integration, West Corp. Healthcare Practice