Growth Prospect: Disease Management Program

Posted on February 7, 2011

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When I initially came across this white paper from McKinsey on disease management programs (DMPs), a bell went off because it reminded me of the struggles rural healthcare providers discussed at the various rural health conferences I have attended recently.  McKinsey defines a DMP as a “standardized, coordinated set of evidence-based interventions whose goals are to enhance the patients’ health and quality of life, reduce the need for hospitalization and other costly treatments, and thereby lower health care spending.”  The reason DMPs are needed is because they can effectively and proactively cut the costs for treating “lifestyle diseases”—diabetes, heart disease, asthma, hypertension, obesity, pulmonary disease—which account for an extreme majority (80+%) of all healthcare treatment costs.

The reason the above diseases are such a problem is because of the way we Americans, not just rural Americans, live our lives.  Poor dietary choices, physical inactivity, stress, tobacco and alcohol use, among others, have created many of these health problems—problems that are chronic and expensive.

The DMP  idea is not new; they have apparently been around over twenty years. However now that lifestyle diseases are such a large part of healthcare spending, and the problems are so endemic to the population, I find them hard to ignore. Regardless of cost, each hospital or system should have a DMP in place.

McKinsey’s research identified five traits for successful programs:

  • program size
  • simplicity of design
  • focus on patients’ needs
  • ability to easily collect data and analyze results
  • presence of incentives for all participants

Much like electronic medical records (EMR), it seems there are economies of scale involved and each hospital need not have their own; organizations can participate as members in a larger plan encompassing multiple organizations. In healthcare, there is savings in numbers. And as with any other market segmentation, programs need enough difference to tailor solutions to patient populations, but not to the level of each individual receiving customized instructions because the economies of scale would be forfeited.

DMPs are intriguing to me because they force healthcare to perform in an integrated way toward a common outcome, and anything that further integrates what I feel is a collection of unitized activities sounds like improvement. Also, for DMPs to be successful they must focus on patient needs, which means couching treatment and education in ways patients can understand and absorb—not in the world of the care provider. Care decisions are actually strategic and even creative, driven by data (neutral feedback).

An unfortunate reality is people are often not proactive about their health; they almost need to experience a tragedy to elicit change in their life. With lifestyle diseases, this is usually too late to do much good in the long-term; instead of prevention, the operating word is “cope”.  Also, Americans respond to instant gratification, and DMPs not only take years to put in place from an administrative standpoint, in many cases they take years to see significant results.

Still, they appear to be the only way to efficiently deal with entire populations who suffer from similar ailments. A community leadership group I participate in, JCCI Forward, is studying the effects of lifestyle choices on long-term health for my generation in its latest issue forum. If I can learn what to do every day, maybe I can head off suffering later in life which appears to be the cumulative effect of many small, bad choices over decades.  That’s my DMP for now. Either way, DMPs will be around in some form.

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Posted in: Growth Prospect