A Summary of the Latest Population Health Management Journal
Posted Jul 05 2009 9:47pm
It's that time again. The latest issue of Population Health Management is out and you'd read it if you weren't so busy with other stuff. After all, PHM is your window into the latest goings-on in the disease management community, its information gives you and your company a competitive advantage and quoting from it impresses policy makers, bosses and colleagues. Good thing you read the Disease Management Care Blog: it has the information you want in a format you can quickly use.
Check it out and decide just which articles you really need to read and which ones are just FYI. So, without further ado......
In this ‘ Point of View,’ the veteran Robert Stone of Healthways discusses the maturation of the disease management industry with a special emphasis on the insurers' eternal choice of ‘build or buy.' According to Mr. Stone, insurers want mutually supportive and broad-based health, wellness, prevention, case and disease management on one platform that are all built to last and are adequately capitalized. For those that are foolish enough to think about building, he cautions the availability of tools is not synonymous with an ability to use them. A telling quote: ‘Price is not the best indicator of ultimate value.’
In this article, Harry Leider of Ameritox, David Mirkin of Milliman and Christobel Selecky of LifeMasters reminisce about the recently concluded Ninth Population Health and Disease Management Colloquium. Harry pointed out there were presentations about conditions that have been largely ignored by the industry, such as chronic pain, autism, migraine and psychiatric conditions. David reviewed how unsettled the science is of using actuarial trends to estimate the economic impact of disease management programs. Christobel detailed how there is a growing emphaisis in her company and among others in maximizing patient activation. Good quote from Ms. Selecky about trending: “I wonder if people arent’ just shell-shocked with trying to come up with a methodology – once you think you have it nailed down, something squirts out the other end.”
Thomas Foels, Sharon Hewner: Integrating pay for performance with educational strategies to improve diabetes care. This describes how Independent Health of Western New York State compensated physicians (60 to 70 cents PMPM plus CME) to conduct reviews of their own charts for diabetes care quality. Physicians were then provided summary data that included an estimate of the patient’s overall burden of illness along with suggestions for improvement. 84% of the physicians participated, and over time there were at least 10 percentage point gains in the usual measures of blood pressure (less than 130/70), LDL (less than 100) and A1c (less than 7). The authors say – with very little detail - that they saved money. The DMCB thinks this is was an interesting article because this was more of a pay for ‘quality improvement program’ (? P4QI?) than a typical pay for performance (P4P) program: that seems unique. Kudos to the authors for this quote: ‘There were several limitations to this study, thanks to the lack of a control group, a small sample size per practice site, underrepresentation of rural and small practices and the selection of patients used in the survey based on a claims profile.' The DMCB says this is promising and some more research is needed.