This approach, of course, contrasts with classic carve-out commercial care management programs, which can implement full programs in a matter of months. While that's an important strength, the DMCB wonders if gradual intrusions into a physician network in a slow one-nurse-at-a-time manner is a 'hare versus tortoise' case study. Making the countless local adjustments, achieving physician buy-in and easing in adequate funding from multiple sources may ultimately be a better approach than dropping a one-size-fits-all program on an unsuspecting physician network with a sticker-shock multi-million dollar budget. All health care is local and physicians need time to adjust.
This may account for some of the travails of some of the for-profit disease management programs with grumpy physicians and gimme-a-one-year-ROI Chief Financial Officers. It may also account for the success of the disease management programs of the large integrated delivery systems, who are in this for the long haul.