Managed Healthcare Executive - January 2009 - (Page 18) { SPECIAL REPORT } 5 New Realities of By Elaine Zablocki Disease Management Challenge your expectations of disease management O 18 ver the past decade, MCOs have turned to disease management to improve outcomes for patients as well as to gain nancial returns. Now experienced industry observers are asking whether disease management is experiencing backlash or if it has reached the tipping point. In particular, CMS lowered its projected savings target for the Medicare Health Support Program from 5% to budget neutrality, announcing that the project had not met its savings goal. Phase 1 ended August 31, 2008, and JANUARY 2009 CMS is still assessing the results. Disease management strategies still have bene ts, but plans and employers must face new realities in order to truly put DM in context. 1 agement programs,” he says. “One reason that’s changing has been DM vendors’ tendency to exaggerate the potential return on investment [ROI] on their programs.” Vendors might o er contracts saying MCOs are building their own they will return their fees if the promDM programs ised ROI isn’t achieved. However, calMCOs are creating their own disease culating ROI is a highly controversial management programs more often, ac- issue, and many “reconciliations” turn cording to Ariel Linden, DrPH, MS, ugly when the vendor claims a large president of the Linden Consulting ROI and the customer disagrees. Group, Hillsboro, Ore. “I have been brought in as an indepen“Over the past decade MCOs opted dent third party in several cases to perto buy rather than build disease man- form an evaluation to settle the dispute,” Ralf Hiemisch/fStop/Getty Images
Table of Contents Feed for the Digital Edition of Managed Healthcare Executive - January 2009 Managed Healthcare Executive - January 2009 Contents Editorial Advisors For Your Benefit News Analysis Politics & Policy Letter of the Law Managed Care Outlook New Day 5 New Realities of Disease Management Pharmacy Best Practices Health Management Technology State Report: Hawaii MHE Resource Ad/Edit Index Managed Healthcare Executive - January 2009 Managed Healthcare Executive - January 2009 - Managed Healthcare Executive - January 2009 (Page Cover1) Managed Healthcare Executive - January 2009 - Managed Healthcare Executive - January 2009 (Page Cover2) Managed Healthcare Executive - January 2009 - Contents (Page 1) Managed Healthcare Executive - January 2009 - Editorial Advisors (Page 2) Managed Healthcare Executive - January 2009 - Editorial Advisors (Page 3) Managed Healthcare Executive - January 2009 - For Your Benefit (Page 4) Managed Healthcare Executive - January 2009 - For Your Benefit (Page 5) Managed Healthcare Executive - January 2009 - For Your Benefit (Page 6) Managed Healthcare Executive - January 2009 - News Analysis (Page 7) Managed Healthcare Executive - January 2009 - News Analysis (Page 8) Managed Healthcare Executive - January 2009 - News Analysis (Page 9) Managed Healthcare Executive - January 2009 - Politics & Policy (Page 10) Managed Healthcare Executive - January 2009 - Letter of the Law (Page 11) Managed Healthcare Executive - January 2009 - Managed Care Outlook (Page 12) Managed Healthcare Executive - January 2009 - New Day (Page 13) Managed Healthcare Executive - January 2009 - New Day (Page 14) Managed Healthcare Executive - January 2009 - New Day (Page 15) Managed Healthcare Executive - January 2009 - New Day (Page 16) Managed Healthcare Executive - January 2009 - New Day (Page 17) Managed Healthcare Executive - January 2009 - 5 New Realities of Disease Management (Page 18) Managed Healthcare Executive - January 2009 - 5 New Realities of Disease Management (Page 19) Managed Healthcare Executive - January 2009 - 5 New Realities of Disease Management (Page 20) Managed Healthcare Executive - January 2009 - Pharmacy Best Practices (Page 21) Managed Healthcare Executive - January 2009 - Pharmacy Best Practices (Page 22) Managed Healthcare Executive - January 2009 - Pharmacy Best Practices (Page 23) Managed Healthcare Executive - January 2009 - Pharmacy Best Practices (Page 24) Managed Healthcare Executive - January 2009 - Health Management (Page 25) Managed Healthcare Executive - January 2009 - Health Management (Page 26) Managed Healthcare Executive - January 2009 - Technology (Page 27) Managed Healthcare Executive - January 2009 - Technology (Page 28) Managed Healthcare Executive - January 2009 - State Report: Hawaii (Page 29) Managed Healthcare Executive - January 2009 - MHE Resource (Page 30) Managed Healthcare Executive - January 2009 - Ad/Edit Index (Page 31) Managed Healthcare Executive - January 2009 - Ad/Edit Index (Page 32) Managed Healthcare Executive - January 2009 - Ad/Edit Index (Page Cover3) Managed Healthcare Executive - January 2009 - Ad/Edit Index (Page Cover4)
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