Disease Management Update
Volume V, No. 37
January 29, 2009
Dear Healthcare Intelligence Network Client,
In this economic downturn, cost savings from DM are paramount. This week's update compares the popularity of and savings from DM and wellness programs versus CDHPs and features a study which concluded that diabetics are more likely to access education programs that encourage better self-management. Read on to find out why.
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Table of Contents
- Survey Examines Healthcare Cost Control Strategies
- Disease Management Q&A: Tracking Program Utilization and Results
- HealthSounds: Improving Patient Collections in an Unhealthy Economy
- Diabetics More Likely to Access Educational Programs that Encourage Better Self-Management
- Survey of the Month: ED Access and Overcrowding
- 25 Ways Healthcare Economizes on Energy Costs
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1. Survey Examines Healthcare Cost Control Strategies
A recent healthcare survey found the majority of public sector employers are working to control costs by implementing DM and wellness programs, instead of introducing CDHPs. Over half of the public employers who responded to the survey indicate they have implemented a DM (69 percent) or a wellness program (65 percent), while 17 percent have a CDHP in place.
“Public sector respondents are implementing disease management programs not only to improve healthcare costs, but also to improve the quality of healthcare,” said Sally Natchek, senior director of research at the International Foundation of Employee Benefit Plans (IFEBP). “A majority, 81 percent, believe offering a disease management program improves the quality of healthcare for their plan participants.”
The main reasons stated by public employers for not offering a CDHP include: poor fit for organization (35 percent), don’t favor shifting costs to employers (20 percent), waiting until CDHPs are proven effective (18 percent) and expect low participation (18 percent). In addition, nearly three-quarters (74 percent) believe that there is a lack of good data about the cost-effectiveness of CDHPs, and 79 percent stated that wide acceptance of CDHPs is unlikely until they become simpler to navigate.
To learn more about this research, please visit:
2. Disease Management Q&A: Tracking Program Utilization and Results
Each week, healthcare professionals respond to a reader's query on an industry issue. This week's expert is Eric Berman, medical director and chairman of health policy, Horizon BCBS of NJ.
Question: How are you tracking program utilization and results?
Response: (Dr. Eric Berman) We have invested heavily in our information services department. We look at episodic treatment groups, and we get pharmacy and outpatient laboratory data on each member. We run reports to see the utilization for different disease entities. It would be very hard for somebody to cheat the system if they had a BMI of 35 and claimed they had hypertension, but they never received any medication for that. We would see that from our data warehouse. It's not designed to be an oversight or a "Big Brother" situation. It gives us an idea of the cost of healthcare and utilization and tests effectiveness of these health and education programs. This gives us a handle on the ROI and demonstrates the decreased usage of outpatient labs, surgeries and pharmaceuticals. This hopefully makes our population healthier through complex case management and DM activities.
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3. HealthSounds Podcast: Improving Patient Collections in an Unhealthy Economy
With a revenue cycle that is measured by claims denials, collaborative data mining by billing and IT can identify origins of financial "bleeding" and turn these problems into actionable items, explain Beacon Partner experts Kevin Burchill, director; Sean McDonagh, practice director; and Ben Tobin, management consultant. Patient-friendly IT can also improve the patient experience on the front end while obtaining data to improve collections on the back end. This is a practice frequently employed by more financially robust providers. The three experts also debate the merits of offering patient discounts for prompt payment and placing patient credit reports in providers' hands.
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Diabetics More Likely to Access Educational Programs that Encourage Better Self-Management
A new study has found that people with diabetes who did not have access to a family physician were less likely to seek education and counseling aimed at helping them manage their condition more effectively compared to those who received regular primary care. Those who attended such special diabetes education programs were more likely to go for retinal screening which is aimed at detecting and preventing vision loss, a serious complication of poorly controlled diabetes. The aim of the study was to identify predictors of attendance at a diabetes education center (DEC).
“We know that self-management, which is the purpose of DEC programs, is an essential component of care for people with diabetes,” says Baiju R. Shah, M.D., who conducted the study. “But we wanted to know whether attendance at DEC programs could be linked to better quality of care for people with diabetes.”
The study found that 30 percent of survey participants reported having attended DEC classes in 2002. Those most likely to attend classes were those with a shorter duration of diabetes, and those receiving regular primary care or care from a diabetes specialist. People with diabetes who had attended a DEC were more likely to receive a retinal screening examination in the following two years than those with diabetes did not attend.
To learn more about this research, please visit:
5. Survey of the Month: ED Access and Overcrowding
An economy that is creating more unemployed and uninsured individuals is just one factor contributing to a rise in ER use and a decline in patient satisfaction. In its National Report Card on the State of Emergency Medicine for 2009, the American College of Emergency Physicians has given the United States an overall grade of C-, largely due to poor ratings for access to emergency care. Is emergency room overcrowding an issue for your organization, and if so, how are you responding to this? Complete HIN's Survey of the Month on emergency room access and overcrowding and receive a free executive summary of the compiled results.
To participate in this survey and receive its results, please visit:
6. 25 Ways Healthcare Economizes on Energy Costs
Faced with volatile fuel costs, the healthcare industry is turning up the heat on energy conservation. In response to an online HIN survey, nearly 100 healthcare organizations shared their ideas for reducing the impact of an unstable energy environment on profits, patients, members and employees.
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