Tuesday, February 3, 2009

The Interview with Tracey Moorhead. Insights About the State of Disease Management

Tracey Moorhead, President and CEO of DMAA was interviewed by none other than the Health Care Blog’s, Matthew Holt. Is the Disease Management Care Blog jealous? Even if it was, it wouldn’t mention it here, but it and the DMCB spouse do look forward to the day when it achieves the HCB’s level of sophistication, gravitas, readership and ad revenue. But it digresses…..

The podcast is well worth a listen, if for no other reason than to hear the repartee between the skeptical Mr. Holt and the optimistic and confident Ms. Moorehead. Realizing that not everyone has 34 minutes to spare (and may not be willing to put up with the periodic buzzing in the recording), here is a brief summary of the better learning points. The DMCB will keep these in its intellectual tool box and keep handy to thwart doubters, stymie naysayers and verbally smote nattering nabobs. You can also, because you read it here:

Remember that CBO report that said disease management doesn’t save money? Mr. Holt sure did, but Ms. Moorhead coolly responded by pointing out that much of the research used in that report was outdated. In response, the DMAA has opened and maintained a regular dialogue with CBO that includes a regular feed of up-to-date literature along with face-to-face meetings. As a result, CBO is better able to stay current with the rapidly changing science of population management, which may have, in turn, helped them craft this later report. The DMCB summarized it here.

And how about that Medicare Health Support? Out of date also, rejoined Ms. Moorhead. Those one-size-fits-all mass recruiting call center programs have gone the way of pneumoencephalogram and doctors' awareness of Pott’s Disease quicker than you can say ‘Tom Daschle’s history.’ In contrast, other successful public sector programs have not been hampered by MHS-style delays or an inability to update their clinical operations, which should tell you something. In addition, a gauge of MHS’ success is not just savings, it’s satisfaction and clinical outcomes, both of which have shown improvements. Keep in mind that the original law that launched MHS did not intend for it to achieve savings, only be budget neutral. Last but not least, stay tuned. A final report has yet to be issued and additional analyses may show that some subpopulations did benefit from reduced claims expense.

What about the future? Well, Ms. Moorhead says it is so bright, she’s gotta wear shades. Medicare was originally designed for an acute care model and everyone, and she means everyone, understands it needs to be changed to support a long term care model. She is optimistic that there will be a convergence of other care models such as the medical home. She is also very confident that the DMAA’s members are committed to the centrality of the physician and believe disease management is one resource that can help them. In fact, some vendors are already partnering and successfuly collaborating with some physician practices.

Finally, said Ms. Moorhead, there is a growing body of evidence that shows population-based care coordination works, especially if the emphasis is about quality of health care, not the return on investment savings. And don’t just listen to her say that, because there are champions of disease management on the Hill and in the Administration.

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