Measuring and Reporting the Performance of Disease Management Programs

by Soeren Mattke, Giacomo Bergamo, Aruna Balakrishnan, Steven Martino, Nicholas V. Vakkur

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Abstract

Health care costs in the United States are rising dramatically and are expected to continue growing faster than the overall economy. Despite the high costs, the quality of care delivered by the health care system remains low. Vulnerable patients with chronic conditions consume the lion's share of the health care resources, rendering their care an obvious target for improving effectiveness and efficiency of care. A promising approach to bridge the gaps in the health care system and improve management of patients with chronic conditions is a class of interventions known generally as disease management. This paper presents the first comprehensive methodology for measuring and reporting the performance of disease management programs-a Disease Management Report Card-that is built on a conceptual framework covering the relevant components of the intervention; uses statistical techniques to attribute changes in the health, utilization, and behavior of the target population to the intervention; and a sampling method that avoids common sources of bias. The methodology would allow a disease management vendor to fairly and credibly demonstrate its performance to current and future clients. Widespread adoption of standardized reporting would facilitate client choice and potentially stimulate ongoing improvements in the delivery of services.

Table of Contents

  • Chapter One

    Introduction

  • Chapter Two

    The Context and Rationale for a Disease Management Report Card

  • Chapter Three

    Design Approach to the Development of a Disease Management Performance Reporting System

  • Chapter Four

    A Conceptual Framework for Disease Management

  • Chapter Five

    Implementation of the Framework

  • Chapter Six

    Issues In Creating a Reporting format for the Measurement System

  • Appendix A

    Measuring Self-Efficacy

  • Appendix B

    Clinical Measures with Guidelines

  • Appendix C

    Estimation Procedure for Risk Adjustment

  • Appendix D

    Survey Instruments for Health-Related Productivity

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