Disease management: A dose of cost prevention?
As health care costs become an increasingly tougher pill to swallow, disease management programs have emerged as an effective strategy to help individuals with chronic illnesses better manage their conditions and get health care costs under control. At the same time, the occurrence of chronic disease is on the rise. Studies from the Centers for Disease Control and Prevention have found that more than 90 million Americans now live with chronic conditions. (1)
Research conducted by Aetna shows that while disease management is still developing, it's one of the fastest growing areas in health care with increasing enthusiasm in both the private sector and in government. (2) Disease management uses evidence-based guidelines and standardized outcomes and data assessment. Programs usually include staff support that routinely contacts the patient's doctor to ensure their plan of care reflects science-based standards of care applicable to the patient's condition. Disease management programs are targeted to conditions that can be influenced by patient monitoring and intervention, some of which include diabetes, asthma, low back pain, chronic heart failure and coronary artery disease. Patient self-care is fundamental and essential to the process, with information and support provided to help the patient better manage their own health. Programs are designed to help patients take action now, before conditions worsen, by providing access to information, health care reminders, answers to questions, encouraging support and patient monitoring. A clean bill of healthWhile chronic disease has reached epidemic proportions, Americans have the opportunity to wipe the slate clean and work toward improved health. In fact, many chronic diseases are preventable. For example, a February 2005 study by the National Institutes of Health revealed that heart disease is preventable just by leading a healthy lifestyle -- such as maintaining a healthy weight, exercising regularly and eating right -- which can lower Americans' risk by as much as 82 percent. Meanwhile, employers must face the ramifications of chronic conditions in the workplace, primarily employee presenteesim and absenteeism. An October 2004 Harvard Business Review article stated that presenteesim (a term applied to employees who go to work feeling poorly) results in a loss of productivity and costs American businesses over $150 billion per year in lost productivity. "Employees who are dealing with a chronic condition may not be fully engaged in their jobs due to the condition itself and the psychosocial and work-life issues that oftentimes accompany these conditions," said Shannon Rickert, Ceridian product manager. "While this can lead to diminished productivity, employees who enroll in disease management programs and comply with their doctor's recommendations can better manage their condition and be more productive in their jobs." Employers are realizing the importance of having a sound disease management program. According to a study by Mercer Human Resource Consulting, 67 percent of large employers used disease management programs last year, up from 58 percent in 2004. What comprises a sound program? According to the Disease Management Association of America, disease management must include the following six components:
- Population identification processes.
- Evidence-based practice guidelines.
- Collaborative practice models to include physician and support-service providers.
- Patient self-management education.
- Process and outcomes measurement, evaluation and management.
- Routine reporting/feedback loop (may include communication with the patient, physician, health plan sponsor and ancillary providers and practice profiling).
"Employers can add to the effectiveness of disease management by offering other health and wellness programs, which supports a holistic, fully-integrated approach by offering services that complete the continuum of care from prevention to condition management," said Rickert. "The key components of disease management are identification and outreach to those in need of services, since many times employees with the greatest need for disease management intervention may not be the ones to make the call."
Business boosterAccording to Hewitt Associates, approximately only 20 percent of employees incur 80 percent of a company's health care costs. (3) However, a disease management program can be a healthy shot in the arm to help organizations target this sector of the employee population. Ceridian has answered this need with Ceridian Disease Management powered by Matria Healthcare. Our services can deliver proactive strategies aimed at reducing the need for hospitalizations and specialty/acute care and extensive testing for your employees. Your company can boost its bottom line by reducing costs and improving self-management of conditions of the small population that accounts for the highest percentage of health care claim costs. Ceridian Disease Management services are designed to improve the health and wellness of your employees, reduce health care costs by leveraging technology and clinical expertise, and address the costs that you and your employees face today -- and tomorrow. Contact a Ceridian representative to learn how a disease management program can help your employees spend less time thinking about their illnesses and more time contributing to your company's success. Sources
- "Healthy Aging: Preventing Disease and Improving Quality of Life Among Older Americans," August 2004.
- "e.Briefing," 2005.
