Piyush Gupta

CHRONIC DISEASE LIFECYCLE MANAGEMENT By CA Piyush K. Gupta CHRONIC DISEASE LIFECYCLE MANAGEMENT What is Chronic disease? The World Health Organization states that chronic diseases, are not passed from person to person. They are of long duration and generally slow progression. The four main types … are cardiovascular diseases (like heart attacks and stroke), cancers, chronic respiratory diseases (such as chronic obstructed pulmonary disease and asthma) and diabetes. The term chronic is often applied when the course of the disease lasts for more than three months. It generally cannot be prevented by vaccines or cured by medication, nor do they just disappear. Facts about Chronic Disease Every day, millions of people with chronic diseases struggle to manage their symptoms. ❖ About 80% of older adults have one chronic disease. ❖ 68.4% of Medicare beneficiaries have two or more chronic diseases and 36.4% have four or more. ❖ Chronic diseases can affect a person’s ability to perform important activities, restricting their engagement in life and their enjoyment of family and friends. ❖ More than two-thirds of all health care costs are for treating chronic diseases. ❖ 95% of health care costs for older Americans can be attributed to chronic diseases. ❖ Less than 1% of health care dollars are spent on prevention to improve overall health. Chronic Disease Lifecycle Management Chronic disease management comprises a defined set of interventions mainly aimed at providing high-quality healthcare and a better quality of life to patients. Chronic disease management services include a variety of services, such as multidisciplinary care, guidelines for the self-management of the chronic disease condition, and guidance for healthy behavioral change, to increase awareness about various diseases. Chronic care management is used for dealing with a wide variety of diseases, such as depression, cardiovascular disorders, obesity, neurological disorders, etc. 2 CHRONIC DISEASE LIFECYCLE MANAGEMENT Market Segmentation The Global Chronic Disease Management Market has been segmented into solution, delivery mode, application, and end user. o By solution, the market has been segmented into educational solution, implementation solution, consulting solution, and others. o On the application, the market has been segmented into safety arthritis, cardiovascular disease, cancer, diabetes, and others. o Based on delivery mode, the market has been segmented into cloud-based, onpremises, and web-based. o Based on end-user, the market has been segmented into providers, payers, and others. Key Players o Global Players – TriZetto Corporation, Pegasystems Inc. , Phytel Inc, Wellcentive Inc, AxisPoint Health o Indian Players – Infosys Limited, Practo, Portea, lybrae, Uberhealth, Nightingales, Health Heal Market Size The global chronic disease management market was valued at approximately USD 3.92 billion in 2018 and is expected to generate around USD 10.3 billion by 2024, at a CAGR of around 17.5 percent between 2019 and 2024. The healthcare apps market in India was valued at INR 27.01 Bn in 2018 and is estimated to reach INR 138.00 Bn by 2024, expanding at a CAGR of ~31.61% during the- period. 3 The driving factors that are responsible for the driving factors are rise in the chronic diseases, rise in the number of people for their health-conscious mentality, and advancement in the technology. The Asia Pacific is considered to be the fastest growing market due to the rise in the geriatric population, adoption of the healthcare facilities provided by the private and public entities and more. CHRONIC DISEASE LIFECYCLE MANAGEMENT FINANCIAL MATRIX Portea Medical is a provider of home healthcare services that includes primary care, chronic disease management, physiotherapy and counseling. It specializes in geriatric, post-operative, palliative care and physiotherapy. The company provides home visits from physiotherapists, nurses, and doctors Portea's medical team operational in: Ahmedabad Bangalore, Baroda, Chandigarh, Chennai, Cochin, Faridabad, Ghaziabad, Gurgaon, Hyderabad, Indore, Jaipur, Kolkata, Lucknow, Mumbai, NCR, Pune, Vijayawada. Estimated Annual Revenue Portea Medical total Funding Portea Medical latest funding size Time since last funding Portea Medical investors $38.8M $76.1 m $3.57 m Nov 2017 Accel Partners, Qualcomm Ventures, International Finance Corporation, VenturEast, Sabre Partners, IFC Venture Capital Group, MEMG CDC Portea was founded with a vision to introduce the US home healthcare model in India. Since then, Portea has acquired three startups including Medybiz Pharma, Health Mantra and PSTakeCare. Medybiz provides medicines deliveries to the patients’ locations Health Mantra provides various medical equipment such as respiratory or oxygen equipment and supplies to hospital ICUs. PSTakeCare helps make the process for seeking surgical care hassle-free. The company set up the entire ICU care at home and managed the required services at home, including for oncology and other support services. “We have always put the customers at the centre. As we started with a few home healthcare services, we soon realised that we had to add more services that essentially supplement our core services. The patients needed equipment and pharmacy” 4 CHRONIC DISEASE LIFECYCLE MANAGEMENT Allscripts is a company that provides healthcare information technology solutions that advance clinical, financial and operational results. It offers electronic health record (EHR), financial management, and population health management solutions to hospitals, health systems, physician practices, and healthcare facilities. Its open connected health platform includes care coordination, patient engagement, connectivity, data aggregation, and analytics. FINANCIAL MATRIX Estimated Annual Revenue Status Market Capitalization Revenue Growth EV/EBIT EV/CFO Financial Leverage $ 1.8 Bn Listed Company on NASDAQ $ 1 Bn 17% -219.6 x -544.9 x 2.6 x 5 CHRONIC DISEASE LIFECYCLE MANAGEMENT IMPACT OF CORONAVIRUS? Chronic disease management and treatment adherence are taking a pretty serious hit as of late, and that is largely thanks to the spread of the novel coronavirus, according to data reported by Evidation. As the virus continues to loom large over the nation, patients are fearful of engaging with the healthcare system, even for needs unrelated to COVID-19. Overall, about one-fifth of patients regardless of disease state are worried about maintaining their health during the coronavirus outbreak. Over half are worried about visiting the doctor’s office Strong patient engagement in care plans has long been the bedrock of chronic disease management, with frequent low-acuity check-ins with primary care providers and specialists being a key component of that care. But now with social distancing protocol and concerns about coronavirus spread in healthcare facilities, those management strategies may be at risk. Telehealth is the future—and the future has arrived Telehealth has been lauded as a key technology in this scenario. A patient should be able to consult with her doctor regarding her chronic disease management using the remote tool, thus keeping both parties safe from the virus. Among those with a chronic illness who saw disruptions in care access, telehealth was slightly more effective. The shift to telemedicine use for chronic disease management is a great step forward, with or without coronavirus concerns. The convenient care option is a boon for care access and patient experience. A recent paper from The American Journal of Managed Care discussed the need for and challenges to incorporating telemedicine amidst the COVID-19 pandemic. It concluded that “although certain legal, regulatory, and reimbursement challenges remain, the COVID-19 outbreak may be the right impetus for lawmakers and regulatory agencies to promulgate further measures that facilitate more widespread adoption of telemedicine.” In less than a decade we’ve seen the likes of MERS, Ebola, Zika virus and COVID-19. The latest one has shown the importance of telemedicine and key stakeholders should embrace the technology and make it an integral part of the healthcare system. This will help work towards the digital health agenda while also preparing for an eventual emergency 6 CHRONIC DISEASE LIFECYCLE MANAGEMENT Sources Crunchbase Craft.co Pitchbook Owler Market Research Future report (Report extracts available in public domain is used) ➢ Medicalbuyer.co ➢ Healthworld.com ➢ ➢ ➢ ➢ ➢ ➢ The Insight Partners 7