US Governor Edward G. Rendell signed two executive orders to improve how Pennsylvanians with chronic disease receive health care in the future. Both initiatives are part of the Governor?s Prescription for Pennsylvania health care reform plan.
?I am establishing a Chronic Care Management Commission today that will be responsible for developing the process to effectively manage chronic disease across the state,? Governor Rendell said. ?About 78 percent of all health care costs can be traced to 20 percent of all patients — those with chronic diseases. We cannot reduce the occurrence and cost of chronic diseases without aggressively addressing prevention, detection and treatment in a comprehensive, pro-active way, and setting that up will be the job of this commission.
?The second order establishes the Office of Health Equity in the Department of Health. The Office of Health Equity and its advisory committee will be charged with eliminating disparities in health care access and quality based on factors such as race, gender, geographic location and income, especially as these factors relate to incidence and mortality rates for chronic diseases.?
The Governor was joined at the news conference by the Pennsylvania Department of Health and the Pennsylvania Diabetes Action Partnership to release the first Pennsylvania Diabetes Action Plan to help improve diabetes education, early diagnosis and care. He said the report underscored the need for the chronic care and health disparities initiatives that he initiated by today?s executive orders.
?Diabetes is a major public health problem that is taking a serious human and economic toll on all Pennsylvanians,? said Governor Rendell. ?The Diabetes Action Plan is the state?s first blueprint for coordinating the efforts of health officials and health care providers to prevent and control diabetes, not only for the sake of the nearly 800,000 Pennsylvanians currently affected by this disease, but for future generations.?
The Governor recognized the work of the co-chairs of the Pennsylvania Diabetes Action Partnership: University of Pittsburgh Diabetes Institute Executive Director Linda Siminerio, R.N., Ph.D; and Robert A. Gabbay, M.D., Ph.D, executive director of the Penn State Diabetes Center at the Penn State College of Medicine.
?The Diabetes Action Plan is in concert with Governor Rendell?s plan to address chronic disease management in Pennsylvania,? Dr. Siminerio said. ?We hope that it will serve as a resource and a catalyst for positive change in our health care delivery systems.?
?We all recognize that we cannot take a ?business-as-usual approach? in the midst of an epidemic, and that?s why we are committed to improving the lives of those with diabetes through this important, organized approach,? said Dr. Gabbay. ?This is a big step forward toward achieving that goal.?
Also standing in support of the Governor?s chronic care initiative during the signing of the executive orders were representatives from a host of organizations who will be involved in the chronic care commission, including the University of Pittsburgh Health Plan, Penn State School of Medicine, the Pennsylvania Medical Society, the Hospital Association of Pennsylvania, Independence Blue Cross, Capital Blue Cross, Lehigh Valley Hospital, Temple Health System, Thomas Jefferson University Hospital, Geisinger Health System and the Jewish Health Care Foundation. Many of the organizations served on a chronic care work group with the Governor?s Office of Health Care Reform and helped to develop the recommendations in Prescription for Pennsylvania on the need to change the way care is delivered today for patients with chronic conditions.
?UPMC Health Plan is committed to developing new approaches to the care of chronic diseases,? said Diane P. Holder, president of the insurance services division of the University of Pittsburgh Medical Center. ?We applaud the Governor’s innovative strategy and look forward to working with partners to improve the health of all Pennsylvanians.?
This comprehensive and pro-active Diabetes Action Plan, coupled with the use of the Wagner Chronic Care Model, will be the foundation for the initial stage of the chronic care initiative. The second stage will address other chronic conditions such as depression, asthma, chronic congestive heart disease and lung disease.
?It is critical that we have a chronic disease model that addresses most chronic conditions because patients often suffer from more than one chronic disease at a time,? the Governor said. ?In 2005, hospitals reported more than $1.7 billion in hospital charges for potentially avoidable hospitalizations because patients with chronic conditions did not receive necessary care in the community.?
The Governor said health care disparities exist in Pennsylvania, but nowhere are these problems more evident than in the rates of chronic disease among different populations.
?We need to be sure that all of our health care reform efforts ? but especially those dealing with chronic care prevention and treatment ? work to eliminate disparities and ensure access to quality care for all Pennsylvanians,? the Governor said.
The Diabetes Action Partnership was convened by the Department of Health more than a year ago. It is a diverse, multi-disciplinary partnership of agencies, organizations and individuals who developed the plan to emphasize the use of collaborative efforts to improve diabetes education, early diagnosis and care.
The action plan outlines recommendations in four key areas: surveillance, standards of care, health policy and evaluation. The recommendations are designed to better prepare Pennsylvania to educate the public about diabetes and diabetes prevention, to properly manage the disease and to decrease costly complications.
More than 200 stakeholders, including federal, state and local government agencies, voluntary health organizations, academic institutions, health systems, professional associations and others with an interest in diabetes prevention and control contributed to the development of the Pennsylvania Diabetes Action Plan.
Diabetes affected an estimated 8 percent of Pennsylvania?s population, or 764,000 individuals, in 2005. The rate of diabetes increases dramatically with age and there is a higher prevalence of diabetes among African American adults in Pennsylvania when compared to white adults.
Unless diabetes is properly managed, life threatening and costly complications affecting the eyes, feet, nerves, cardiovascular system and kidneys can develop. Each year, Pennsylvania?s avoidable hospital admission rate for conditions related to diabetes was 24.4-per-1,000 admissions, while the rate for the top 10 percent of states averaged only 5.8-per-1,000 admissions. In 2005, the total cost of potentially avoidable hospitalizations for diabetes was nearly $730 million.
The plan?s development was funded by the Centers for Disease Control and Prevention and a state appropriation for the diabetes program. To view the Pennsylvania Diabetes Action Plan, visit the www.health.state.pa.us.