Preeta Chidambaran, MD, MPH

2006-2007

California Endowment Scholar in Health Policy

Physician-Medical Officer, Center for Medicare, U.S. Department of Health and Human Services; Instructor in Medicine, Harvard Medical School, Boston, MA

Dr. Preeta Chidambaran is a Physician- Medical Officer in the US Department of Health and Human Services (HHS) at the Centers for Medicare and Medicaid Services (CMS). She is currently with the Technology, Coding and Pricing Group (TCPG) at the Center for Medicare. Her areas of expertise include Medicare coding and payment policies, clinical quality improvement, team-based care, and patient engagement.

Dr. Chidambaran has held numerous roles within HHS during the last thirteen years, serving as Physician- Medical Officer in the Center for Medicare, Chronic Care Policy Group (CCPG) at CMS/HHS (2016-2020), and as Medical Officer for Quality at Bureau of Primary Health Care (BPHC) at the Health Resources and Service Administration (HRSA)/HHS (2010-2016). She has received numerous awards such as the CMS Honor Award for COVID- 19 response, CMS Special Achievement award, HRSA Administrator’s citation for outstanding group performance in quality improvement and was selected as a HRSA Senior Leader Fellow.

Dr. Chidambaran is an Instructor in Medicine at Harvard Medical School/Brigham and Women’s hospital since 2007. She is a board-certified internal medicine physician with extensive experience in integrated healthcare delivery and community health. She currently practices internal medicine, primary care in Maryland.  Previously, she worked at Harvard University Health Services in Boston, MA and Kaiser Permanente Medical Group in the San Francisco Bay Area. She is the Co-founder and Board Member of iLearningEngines – a learning technology company for corporate, patient and clinician education.

Dr. Chidambaran received her medical degree from Mahatma Gandhi Institute of Medical Sciences in India. She completed her internal medicine training at Albert Einstein Medical School, NY and Kaiser Permanente in CA. She completed a Health Policy Fellowship at Harvard Medical School and was a California Endowment Scholar in Health Policy at Harvard University. She also received an MPH in Healthcare Management and Policy from the Harvard School of Public Health.

Learn more about the California Endowment Scholars in Health Policy at Harvard University.

 

Comparative Analysis of U.S. and International Chronic Disease Self Management Programs

Background:

Chronic diseases are one of the primary reasons to seek health care and account for over 75% of health care expenditure in the United States. Chronic diseases disproportionately affect the minority population. There is an increasing interest in MA to adapt programs such as the chronic disease self management program CDSMP, which is a lay-led patient education program on a statewide basis as a quality improvement and cost control measure. Such programs have been used successfully in some integrated health care systems on the west coast as well as internationally in several countries. This study aims to analyze these programs and to look at their applicability in the domestic policy process.

Goals:

1. To study the CDSMP domestically and outline specific issues and challenges.
2. To perform an in depth analysis of CDSMP on the international front in 5 countries, the issues and challenges with this model, and future plans in this area.
3. To incorporate the lessons learned from the international programs into the domestic policy process, and make specific policy recommendations.

Methods:

A structured review of current literature via internet research as well as Medline was conducted to evaluate the CDSMP in the U.S. as well as five countries, namely UK, Canada, Australia, Hong Kong/China, and Japan. Standardized questionnaires were sent to international experts in this field to gain specific information about the CDSMP in their respective countries. Key informant interviews were conducted with key stakeholders and experts in the U.S. to gain their perspectives on the relevant issues regarding local CDSMP programs as well as to discuss specific challenges, adaptability of international lessons, and policy changes needed for the future. All of this information was summarized and policy recommendations were made to address chronic disease self management domestically.

Findings:

1. This model works best when integrated with the primary health care system.
2. The model is adaptable across cultures and diverse populations and accordingly it is most effective when developed locally for a specific group rather than a large umbrella program.
3. The model has been shown to increase quality of care, decrease hospitalizations, and save costs.
4. It is important to target these programs specifically to the minority and disadvantaged population. Otherwise, there is a risk of increasing health disparities due to a process of self selection of well-educated and better-off patients getting the most benefit from such programs.
5. The primary challenges with this program have been engaging the health care professionals, recruiting of patients,sustaining the lay led trainer workforce, and addressing long term funding mechanisms.

Recommendations:

1. Increase overall awareness for the importance of health education and CDSMP in chronic disease care.
2. Establish a central agency responsible for maintaining evidence based information, disease registries, quality control and monitoring, and effective communication amongst all the different programs.
3. Integrate CDSMP and health education into the primary care system.
4. Change the reimbursement structure to align with incentives for self management, health education, and prevention and wellness in chronic diseases.
5. Tailor specific programs for the minority and underserved population.

Preceptor:

John McDonough, Executive Director & Grace Moreno, Director of Programs and Planning, Health Care for All