Thursday, February 7, 2008

Cost Effectiveness of the Chronic Care Model?

Along with countless other nattering nabobs of negativity, the Disease Management Blog has been looking for something… ANYTHING… that will ameliorate the cost of chronic illness. So it donned strong reading glasses and made humble pilgrimage to the Improving Chronic Illness Care web site to learn more about the Chronic Care Model. It found this quote:

Cost-effectiveness studies: Currently there are no cost-effectiveness studies on the implementation of the CCM per se, but this group of articles looks at how control of certain diseases, like diabetes, can reduce health care costs.

Excuse me? I thought lack of proof of savings per se was confined to disease management. And physician pay for performance. And consumer cost sharing. And the electronic medical record.

It's enough to give someone a case of the therapeutic nihilisms.

It all comes down to spend vs. consumer expense vs. charges, vs. claims expense vs. direct costs vs. indirect costs vs. $/QALY vs. who knows what else. Wanting to avoid a migraine from thinking too hard about this, the Disease Management Blog turned to, what else but....cable TV!

Witnessing the growing convergence of media and health, it's probably only a matter of time until Bravo launches Project Populationway!

Modeled extravagantly after the Emmy-winning series
Project Runway, four hip, paunchy celebrities with
thousands of dollars’ worth of chronic conditions cast a critical eye toward the
zany interventions dreamed up by our aspiring disease management designers. In one episode, Contestant A deploys a faux animal print tube-top educational brochure combined with Blue-Ray plus WiFi, paired with a stylish if muted high-waisted home monitoring system, outfitted with silver toned blinking lights – now THAT is bling! IVR-enabled and skin-embedded telephony completes this chic yet sensible ensemble. Over in the next room, Contestant B engages a simultaneously classic and radical design when she spot welds a case manager to a spandex bodice. This combo is completed with an over-the-top velour-lined P4P quilt that pushes and pulls the physician components into a trim if retro-disco package suitable for casual afternoon physician video-emailing as well as evening low fat protein shakes with some good friends. Downstairs, contestant C breaks all the rules and then some when he uses crayons, guidelines and cash to whip up a subtle patchwork of khaki, flannel, denim, velvet and chronic care model, energized by an avant-garde black sheath and string of freshwater benefit designs. The winner’s prize package will include getting to author an evidence-based editorial in the New England Journal of Disease Management, being appointed Assistant Director of the CMS Department of the Care Continuum and Populationating (CCAP) and receiving $.03 PMPM.


Katie Coleman, MSPH said...

At last! One cost-effectiveness analysis of the CCM has been published subsequent to the posting of that quote on ICIC's website. See "The Cost Effectiveness of Improving Diabetes Care in U.S. Federally Qualified Community Health Centers." Huang, Zhang, Brown, et al. Health Services Research.
Good news for CCM fans, but more, longer-term research is definitely needed!

Jaan Sidorov said...

thanks katie - well said. I'll look up the reference.