Care Guidance Programs: Transforming Chronic Care Management for a More Equitable Future

We’re excited to share a recent article published in Medical Economics by Tina Graham, COO of Guideway Care, that sheds light on the transformative potential of care guidance programs in the realm of chronic care management (CCM).

CCM plays a pivotal role in bridging the gap between healthcare providers and their vulnerable patients. Those at risk due to health-related social needs often require a higher level of interaction, support and monitoring to activate their health journey effectively. However, this poses a challenge to healthcare organizations already grappling with limited resources.

The article delves into the significant impact of social determinants of health (SDoH) on CCM patients. These non-clinical factors, such as socioeconomic status, education, culture and environment, significantly influence patients’ health outcomes, especially those with chronic conditions. With nearly 80% of a patient’s overall health linked to socioeconomic factors, unaddressed non-clinical issues can lead to barriers in care delivery, treatment adherence and self-care, ultimately burdening healthcare operations.

Care guidance programs are emerging as a valuable solution, proactively activating CCM patients and resolving disparities before they become costly clinical problems. However, the success of such programs relies on a thoughtful approach to roles, responsibilities, technology integration and specialized training.

The article presents evidence that these programs improve care processes, clinical outcomes, and cost-effectiveness. It also highlights the importance of the human element in care guidance, as technology alone cannot replace the patient-provider connection, especially for populations with limited access to digital health tools.

Moreover, care guidance platforms capture SDoH data and disparity-related barrier resolutions, providing essential insights for improving operations and supplementing electronic health records.

The introduction of reimbursement for CCM by the Centers for Medicare & Medicaid Services (CMS) has created new revenue opportunities for healthcare providers. Care guidance programs support various care management models and are aligned with CMS initiatives like the Quality Payment Program (QPP), which emphasizes health equity.

Care guidance is rapidly becoming a vital addition to the portfolio of healthcare organizations. By partnering with outsourced care guidance services, providers can efficiently and cost-effectively offer connected care solutions. This approach aligns with the “Triple Aim” of improving care experiences, advancing population health, and reducing total costs.

To explore the full article and learn more about how care guidance programs are transforming chronic care management, click here.

Guiding the Future of Equitable Healthcare

As your partner, Guideway Care can implement an efficient and effective care guide solution to support your clinical team and deliver on the promise of health equity. Contact us for valuable insights and discover how Guideway Care can make a positive impact on patient outcomes in your community. Let’s work together to drive a more equitable and effective healthcare system.