The disease management industry has come into its own over the past few years. Not only are employers demonstrating robust interest in such programs, but the Centers for Medicare and Medicaid Services has launched a large-scale pilot program aimed at testing the success of such programs with fee-for-service Medicare beneficiaries.
Meanwhile, state Medicaid programs and health insurers are continuing to expand usage of disease management initiatives for their own populations, even introducing financial incentives aimed at boosting participation among enrollees with chronic and high-cost diseases and conditions.
And with the growing demand for consumer-directed health benefit designs, enrollees themselves are starting to discover the ability of disease management programs to help them contain their own out-of-pocket health expenses as well as improve their health.
Nevertheless, disease management firms still face a host of issues. Purchasers are pushing for more reliable evidence of the effectiveness of such programs in improving health outcomes and reducing costs. Many health insurers are continuing to build their own internal disease management capabilities, pulling business away from independent firms. And consolidation among disease management vendors is transforming the industry.
Health Plans and Disease Management: The New Environment examines current disease management strategies and programs used by health insurers to improve outcomes and contain costs. The report evaluates programs that target specific diseases and conditions, including obesity, depression, heart disease and high-risk maternity. Another chapter outlines chronic disease programs aimed at Medicare populations. The report also reviews the implications of new consumer-directed product designs on disease management programs, and assesses the link between specialty pharmacy and disease management programs.
Table of Contents
Chapter 1: Health Plan Strategies for Specific Diseases
Chapter 2: Disease Management Strategies for Medicare and Medicaid Populations
Chapter 3: Employer, Insurer and Product Trends in Disease Management
Chapter 4: Disease Management Strategies in Specialty Pharmacy Programs
Written For
- Health system disease management and contracting directors
- Business executives and marketing managers for disease management vendors
- Physician group administrators and other physician leaders who are involved in DM
- Pharmaceutical company and PBM contracting and DM managers
International orders will be fulfilled in PDF format via email.
