Spotty Chronic Care Management
. Proper management of chronic conditions is essential to good care, and is an especially important task as the population ages.
The good news is that the proportion of the population with their diabetes adequately controlled has improved modestly in the last five years. The bad news is that this varies widely, ranging from 79 percent in the best privately insured plans, to 23 percent in the bottom 10 percent of Medicaid managed care plans.
Ensuring coordination of care is especially critical at the time of discharge from a hospital.
The Commission's scorecard found that patients with congestive heart failure received written care instructions when discharged only half the time—with a gap of 80 percentage points between the top and bottom 10 percent of hospitals. Failure to manage conditions after discharge can result in trips to the emergency room or rehospitalization, with associated human and financial costs.