Health insurers and self-insured employers are leading theadoption of more-personalized and holistic approaches to managingchronic conditions such as diabetes, COPD and depression. The newapproaches aim to change patient behaviors with the aid of digital technologies, thereby lowering healthcare costs, according to Chilmark Research’s report, “Assessing the Market for Condition ManagementSolutions.”

However, provider organizations – many of which still operateunder fee-for-service models – are slower to adopt morecomprehensive programs, at least on a large-scale basis that alsoincludes patients most at risk for developing chronic conditions,according to the report. But as the health care sector moves moretoward “value-based reimbursement” and “risk-based contracting,”adoption of more-comprehensive chronic management programs byproviders will increase.

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“The status quo is primarily the episodic treatment of theseconditions: Delivery of care in high-acuity, high-cost setting,followed by discharge, a vague set of instructions, and radiosilence until a patient returns to receive more high-acuity,high-cost care,” the authors write. “This is an unsustainable,untenable, and unacceptable process for each key stakeholder: Thehealthcare organization delivering the cares, the payer -- andemployer -- paying for the care, and above all the patientreceiving the care.”

Over the past year and a half, an increasing number of digitalhealth solutions targeting specific conditions has emerged,according to the report. These solutions go beyond episodictreatment, and provide more holistic and longitudinal interventionsthat use “low-cost, high-tech touchpoints” to help participantsachieve sustained behavior change that slows or -- in some cases --reverses the pro­gression of their condition.

The most successful condition management programs require ablend of cognitive behavior theory (user experience), behavioraleconomics (incentive design), gamification (program design), anddifferentiation (subsets of patient populations).

Chilmark Research’s report profiles 10 vendors that are “marketleaders,” including GLOOKO in Mountain View, Calif., whose diabetesmanagement system allows patients to sync their monitoring deviceswith their smart­phones and share this data with members of theircare team. The Glooko mobile app and the MyGlooko Web app let userstrack blood glucose and insulin levels alongside data aboutexercise and diet. Using this data, the app analyzes patterns,showing users how physical activity, medication, and carbohy­drateintake all affect blood glucose levels. The app also tracks whenthose good days occur, which helps users see what they did well ormay need to avoid doing. Users can also set alarms that remind themto take medica­tion, exercise, or have a snack.

Providers can use this data to op­timize insulin management,flag at-risk patients based on glycemic control orlifestyle-related factors, and view recommendations for insulinpump changes. According to the company, roughly 60 percent ofGlooko users decrease their risk of hypoglycemia and hyperglycemiaby at least 10 percent, and nearly 30 percent increase theirfrequency of blood glucose testing once they be­gin the Glookoprogram.

Chilmark Research’s report ends with six conclusions: Expectcondition management market activity to increase; view lifestylemanagement as a differentiator; address needs beyond the mostcommon conditions; improve enrollment, engagement functionality;emphasize platforms instead of apps; and “understand that it willtake a village.”

“Few providers, payers, employers, or vendors have the size,strength, and expertise to address the complex care management,lifestyle management, and engagement needs of chronic conditionmanagement on their own,” the authors write. “Strategicpartnerships will be inevitable.”