Creating the Virtual Integrated Delivery System

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by Ken Thorpe and Lydia Ogden

Preventing and more effectively managing chronic illness are critical national health priorities. Patients with chronic disease currently account for three-quarters of overall health spending. Multiple morbidities are common: More than half of Medicare beneficiaries are treated for five or more chronic conditions yearly. Nine chronic ailments account for nearly 60% of the recent rise in Medicare spending—conditions typically treated with prescription drug therapy and managed chiefly by patients at home and in outpatient settings. Despite significant health care outlays, though, chronically ill patients receive just 55% of clinically recommended services, and that gap in care may explain a nontrivial portion of preventable morbidity and premature mortality.
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