Chronic Care
The Chronic Care funding program attempts to address the social determinants of health, such as physical and social environments and individual behaviors as critical elements in addressing chronic disease management. Adoption of the Chronic Care Model illustrates how community resources and policies are as important as health systems in implementing patient care.
In 2010, the funding program focuses on diabetes and expands elements of the chronic care management model, to move beyond diabetes as a specifi c condition and address chronic illness as a whole. Emphasis is on elements addressing overall chronic care management, such as:
• Expanded policy-driven and systems level integration of chronic care management.
• Use of evidence-based interventions addressing conditions beyond diabetes using established strategies in chronic care management.
• Capacity to develop a chronic care management model for different delivery systems (e.g., local health departments, FQHCs, hospitals, etc.).