Improving Chronic Illness Care

Findings from a National Study of Care Management Processes in Large Physician Practices

This article examines the use of evidence-based care management processes by large physician organizations. Care management processes are designed to improve care for people with chronic illness. Over 90 million Americans have a chronic illness and chronic illness is responsible for more than three-quarters of national health care costs.

The authors analyzed data from 538 physician organizations in the United States that had 20 or more physicians and treated at least one of four chronic conditions. The physician organizations completed a telephone survey to identify their use of various care management processes.

Key Findings:

  • On average, physician organizations used just under half (46%) of available care management processes. This is a substantial improvement from 2000-2001, when physician organizations used only 32 percent of available processes.
  • The most common care management processes were electronic registries of patients, designated patient educators, and feedback for physicians on quality of care.
  • The chronic disease most likely to involve use of care management processes was diabetes. Treatment for depression was least likely to have care management processes in place.
  • Larger physician organizations and organizations that focused on patient-centered care or quality improvement processes were more likely to use care management processes. Only 4 percent of physician organizations reported using all available care management processes.

Chronic care management is an increasingly important component of quality health care. While the use of care management processes is increasing, physician organizations have yet to fully utilize these processes across the spectrum of chronic illnesses.