Improving the Healthcare Model for Management of Adults with Sickle Cell Disease in the PPACA Era - Abstract
Sickle cell disease (SCD) is the most common inherited blood disorder and affects approximately 100,000 individuals in the United States. Once confined to childhood, improvements in early diagnosis through universal newborn screening and coordinated pediatric programs for SCD have contributed to an increased lifespan, with patients surviving into adulthood. However, there is a paucity of healthcare resources available for the adult patient population.
SCD has become a chronic condition as patients live into adulthood; therefore, the paradigm of care needs to shift from managing acute conditions to preventing complications and preserving health. Unfortunately, the limited numbers of knowledgeable and available providers, as well as a disorganized healthcare infrastructure, have caused most affected adults to rely on acute care services, leading to increased rates of hospital utilization and higher healthcare costs. For adult patients with SCD (and other chronic conditions) who lack third-party payer coverage, the Patient Protection and Affordable Care Act (PPACA) may alleviate some of these issues in states accepting Medicaid expansion. However, while the PPACA may provide for increased insurance coverage for some patients, it will not increase the number of available providers or improve health outcomes for this patient population. Thus, it is
necessary to create a structured system of care in the United States to manage patients with SCD and their long-term comorbidities and complications.
Summary: A healthcare model that provides a coordinated system of healthcare delivery for adults with SCD is the first step to improve health outcomes.