The frightening connection between the economy and chronic disease

When facing economic uncertainty, some people may avoid certain habits such as buying healthy foods or their gym membership because of the cost. That can lead to development or progression of chronic disease, and stress, anxiety and depression can only worsen bad habits that feed diabetes and heart disease, among others.

In a July Becker's Hospital Review webinar sponsored by Vida, Vida's chief marketing officer, Kevin Knight, moderated a discussion with Richard Frank, MD, senior vice president for medical affairs, and Gretchen Zimmermann, head of cardiometabolic care, about the connection between disease and the economy. They discussed personalized, technology-based solutions to help people effectively self-manage disease. 

Four key takeaways were: 

  1. The economy and chronic disease are connected. It's not just financial fears that impact health during an economic downturn. Other social determinants of health are affected as well. "We're talking about transportation, food insecurity, housing, safety and there are a number of others, all of those in an economic downturn can worsen," Dr. Frank said. The bottom line is that physical health, mental health, social health and financial health are all connected.

  2. All aspects of health are connected. Many solutions available to payers and self-insured employers focus on a single disease, such as diabetes. But the factors that affect one chronic health condition often affect another. Treating these chronic health conditions along with mental health conditions such as stress, depression and anxiety yields better results. "If we treat patients with either under-diagnosed or undiagnosed depression at the same time that we're treating their diabetes, we get a 33% greater reduction in their hemoglobin A1C," Dr. Frank said.

  3. The approach to chronic disease management requires new thinking. Twenty years ago, it was believed that just explaining to people how to manage diet, nutrition and weight loss could help them manage diseases like diabetes. But newer thinking recognizes that behavior change requires more than just education.

    "In general, in America, the healthcare system doesn't play much of a role until that diagnosis comes," Mr. Knight said. "It often comes with some scary medications and lifestyle changes that we need to make. And that makes the stress and the anxiety worse because now we have this scary sounding diagnosis hanging over our head."

    Techniques like those offered through Vida, with personalized attention to mental health, motivational interviewing and cognitive behavioral therapy, have yielded strong outcomes. "What we see over time is that patients are able to sustain those outcomes," Ms. Zimmermann said. "Why? Because we've taught them how to be their own provider. We don't want to be the provider that's holding their hand 24/7 for the rest of their life."

  4. In addition to better patient outcomes, Vida delivers a positive return on investment. Dr. Frank described how foot ulcers, for example, are a major complication of diabetes that cost tens of billions annually. "To the extent that Vida can deploy an intervention, where the cost of the intervention is less than the value it creates, we can then create a return on investment, typically twice as much as the cost of the program and in some instances, three to four times greater than the cost of program," he said. Mr. Knight added that physicians who achieve better outcomes for patients tend to be more engaged in their work.

Taking a holistic approach to disease management that addresses habits and behaviors and coaches self-management can yield better patient outcomes, return on investment and clinician satisfaction. The result of Vida's technology-driven approach is a more personalized, sustainable care plan for the member. 

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