Monday, October 15, 2012

What Happened To "Disease Management?"

Early Disease Management
The Disease Management Care Blog is hard at work rehearsing its Care Continuum Alliance Forum12 Plenary Session that's scheduled later this week. Right now there are 22 slides and they have something for everyone: Laurel and Hardy, Keystone Kops, kittens, witches, Ingmar Bergman and Bill Clinton. 

And that's just for starters.

One of the topics that the DMCB will tackle is how much "disease management" (DM) has changed over the past two decades.

When DM first started, many believed it was "the" solution.  It focused solely on chronic illness.  It promoted patient consumerism. While there was some shared risk, the business model was ultimately based on fee-for-service payment mechanisms that pursued a "return on investment."  It sought 100% patient outreach. It alienated many physicians.  It didn't invest in research. The industry suffered from hubris. Many believed it was a silver bullet.  It used nurses.

What a difference 20 years makes.

Now, the population health management service providers view themselves as part of the solution. It spans the full continuum of care, including case management, prevention and wellness. It promotes patient-centric collaborative teaming.  Instead of FFS, its business model is one of value and efficiency that reduces avoidable claims and optimizes trend.  It uses risk stratification to selectively enroll persons who will benefit the most. It is achieving physician buy in. It has invested in rigorous research and a host of studies since then demonstrate increases in quality and savings.  It has sought out partnerships and collaborations.  Many regard it as a key strategy. Its nurses practice behavioral medicine.

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