State tackling chronic diseases that affect many residents

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Officials said yesterday that Pennsylvania is beginning to address the heavy toll taken on its residents by chronic diseases.

A study released earlier this week by the nonprofit Milken Institute found that only five states had more reported chronic disease cases per capita.

The group said that diseases such as cancer, diabetes, heart disease, hypertension, stroke, mental disorders and pulmonary conditions cost the nation more than $1 trillion annually in medical treatment and lost work productivity. In Pennsylvania, the toll in 2003 was $64 billion.

Rosemarie Greco, director of the state Office of Health Care Reform, said the report's conclusions were not a surprise, in part because Pennsylvania has an aging population that is prone to chronic disease.

"It's distressing to read our rankings," she said. But she noted that the state has taken "a very positive step" by creating a commission to improve management of chronic diseases.

The commission is expected to deliver a plan by Dec. 31 recommending changes needed to implement a model for improving chronic care statewide. If Gov. Ed Rendell approves the plan, some changes could begin to be implemented next year.

The 43-member panel includes officials from leading health insurers, hospitals, unions and other groups, as well as six ex officio members who lead state agencies.

Many experts have expressed concerns that the current health care system, which focuses on acute care, is not optimally organized to care for people with chronic diseases. Payment systems, for example, generally do not provide incentives for health professionals to spend time with patients to help them manage their chronic conditions.

When he announced the chronic care commission earlier this year, the governor said about 78 percent of health care costs can be traced to about 20 percent of patients with chronic diseases.

Diane Holder, president of UPMC Health Plan, said the commission helps draw public attention "to the fact that we have very serious problems." She co-chairs the group along with Ms. Greco and Anne Morrissey, president of Pennsylvania Managed Care, Keystone Mercy and AmeriHealth Mercy health plans.

While regular walking and even moderate weight loss can improve health, Ms. Holder said there are many challenges to addressing the problem of chronic disease.

The commission will seek to build on promising efforts already under way in some communities, she said, and work to determine whether initiatives are improving clinical outcomes and reducing costs.

Joe Fahy can be reached at or 412-263-1722.


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