Health Care at the Crossroads: Strategies for ... - Joint Commission

Health Care at the Crossroads: Strategies for Narrowing the Organ Donation Gap and Protecting Patients
Beyond their roles in preventive screening and
addiction management, managed care plans
are the primary providers of, or access points
to, disease management programs. Currently,
92 percent of private health plans and 81 percent
of Medicaid-only plans operate two or
more disease management programs. 129 Most
commonly, disease management programs
provide support to patients with diabetes,
asthma, coronary artery disease, congestive
heart failure and high-risk pregnancy. 130 In
addition, Medicare is in the process of initiating
disease management demonstration
projects for congestive heart failure, diabetes,
arthritis, hypertension, cancer, stroke, chronic
obstructive pulmonary disease, hyperlipidemia,
end-stage renal disease, and liver
failure. 131
Finally, while modern medicine has made
great strides in preventing, treating and containing
the dire consequences of many diseases,
access to such health care interventions
and even the most basic of primary care, is a
continuing challenge for the 43 million currently
uninsured individuals and the millions
of others expected to join their ranks in the
coming years. 132
INTO THE FUTURE
Once patients receive their live-saving
transplants they often face new health risks.
Immunosuppressive drug therapy is hard on
the body. In fact, from seven to 20 percent of
non-renal transplant patients experience
chronic renal failure within five years of their
transplants. 133 Studies have also shown a
higher risk of post-transplant malignancy related
to immunosuppression. 134 Continued
efforts to improve immunosuppressive drugs
in the short term to reduce undesirable side
effects and adverse outcomes are warranted.
Over the long term, new and emerging science
and technologies offer the potential to alleviate
the problems of graft rejection and failure,
eliminate the risks born from immunosuppressive
therapy, and even create alternative
approaches to closing the organ donation gap.
PRIMARY CARE INTERVENTIONS AND DISEASE MANAGEMENT PROGRAMS THAT CURE,
SLOW OR CONTAIN THE PROGRESSION OF DISEASES TO ORGAN FAILURE NEED
TO BE VIGOROUSLY PURSUED.
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