Interest in disease management is growing, but employers see it as part of a package of services vaguely described as ‘health productivity management.’ Not sure what that means? Neither does the DMCB, but it suspects the DM industry needs to continuously demonstrate value in their customers’ efforts to optimize their human capital.
Dubious claims of return on investment are a persistent headwind against the industry’s acceptance. Maybe the secret sauce in the DMAA Outcomes Guidelines Report still needs to filter into the market place (anyone know of any examples of it being actually used?), but employers really really doubt the precious hard cash they are giving the industry today reduces costs tomorrow.
There is little to distinguish one disease management program from another. Ingredients that can overcome this are a) reach rates b) demonstrating value in data reporting and c) price
Employers believe the disease management industry is in transition and has yet to package wellness, prevention, chronic illness, disability and data integration into an understandable integrated product.
What does this mean?
DM companies are in constant danger of becoming commoditized. Ways to avoid this include:
Since views on health productivity management are variable, there will be a corresponding inexact company-specific ‘sweet-spot’ that exists between one extreme of minimizing your customers’ input versus the other extreme of overburdening your customers with program design and execution. Find that sweet spot.
Since there is variability, contracting will need to be correspondingly flexible and collaborative. Be prepared for new ideas and requests after the ink is dry on the agreement. Some may be costly, some may be dumb but some may be worthwhile and a few may be valuable contributions to the science. An ability to recognize, internalize and leverage the valuable contributions will be a competitive advantage.
One way to overcome doubts on the ROI is to perform and publish more peer-review research. It will probably take a multi-year prospective randomized trial involving huge numbers of participants. Good luck. Another is to see what Don Berwick has to say about research involving complex multi-component programs. Another is to figure out how to demonstrate value in the field of human capital development. The industry needs to engage its critics and customers at those levels.
It will be difficult to reconcile employers’ demands for multi-component integration versus the fracturing of programs across employers, competitors, insurers and providers. While increasing market share in all dimensions of wellness, prevention, chronic illness care and care coordination is one approach, winning will probably depend more on skills in aggregation and ‘coopetition.’