Caring for patients struggling with chronic conditions is more complicated than meets the eye, especially when transitioning them out of an inpatient facility. While it involves plenty of routines, medications, and check-ups, the reality is that patients want to live a life that isn’t defined by their sickness. Unfortunately, this can be tricky, as patients who are very sick display little interest or engagement in their care. Encouraging them to manage their health is often a difficult task. 

Chronic care management, although necessary, comes with many different challenges for both the patient and the medical care provider. The more conditions a patient has, the higher the risk for hospitalization, medication interaction, and mortality. They’ll also need more comprehensive treatment and frequent trips to the doctor, requiring precise coordination among professionals to provide the best care possible.

The Costs 

According to the Office of the Assistant Secretary for Health, 66 percent of the total health care spending is taken up by chronic care management alone, making it the most expensive program. Unfortunately, two out of three Medicare beneficiaries struggle with multiple chronic conditions, which means that chronic care management is even more important than initially thought. As patients with numerous chronic diseases have to pay enormous amounts for their care, Medicare has recently begun paying for these services. Still, it remains a challenge to get reimbursed for these services before the change.

The Geographic Challenges

There are also geographic challenges in chronic care management. Conditions like heart disease, diabetes, and obesity are more prevalent in the southeastern United States. To illustrate this point further, only 10 percent of Maine residents have heart disease, although the state spends nearly $24,000 per patient. However, 16 percent of Texans have heart disease, and it costs approximately $23,000 for each Medicare beneficiary to treat it. 

The Biases

More troubling are the gender, racial, and ethnic gaps in health care, particularly the rate of mortality and surgery outcomes. According to research, non-white patients have a 33 percent higher risk of death after undergoing heart surgery. Meanwhile, another study observed that men were twice more likely to be screened for hepatitis C than women. In that same research, they found that Caribbeans had a much lower predicted probability of being screened for it than other ethnicities. 

The Importance of Chronic Care Management

Chronic care management is fairly new, with its beginnings as recent as the 1980s. Since its establishment, there has been more focus on the research and development of treatments to improve these patients’ quality of life and understand how their conditions affect them. By transitioning patients out of hospitals and into homes with a remote patient monitoring setup, they can live more comfortably and be more invested in their treatment.

Unfortunately, chronic disease is alarmingly common. According to the National Health Council, around 133 million Americans, or 40 percent of the nation’s total population, are afflicted with chronic conditions. The Centers for Disease Control and Prevention state that six in ten adults in the US have a chronic illness, while four in ten have two or more. With so many people requiring chronic care management, healthcare systems need enough health professionals to meet chronically ill patients’ needs.


Chronic care management has allowed patients to enjoy a semblance of normalcy by living at home while receiving the treatment they need. It still has its many challenges, particularly in sourcing enough nurses and healthcare workers to monitor the patient. Fortunately, by deploying a remote patient monitoring system, managing a chronically ill patient’s health is more feasible and affordable.

Medistics Health specializes in simplifying the experience of transitional care and chronic care management through our remote patient monitoring system. We work with patients and providers to develop person-centered care plans and ensure adherence to them. Get in touch with our team of dedicated healthcare professionals today to simplify your patients’ health!

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