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Managed Care April 2006 Maureen Glabman	'Take My Word for It': The Enduring Dispute Over Measuring DM's Economic Value While disease management is now mainstream, it can still be difficult to judge a program's worth. Health plans faced with renewing these contracts have a lot to think about.
Managed Care December 2001	Disease Management Outsourcing As DM shifts its focus to outcomes-based care, the EVP of American Healthways suggests that larger health plans consider outsourcing care of chronic patients.
Managed Care September 2005 John Carroll	DM Industry Confident It Can Hit Medicare Goals Though there are challenges to serving the elderly, the movers and shakers of disease management say that they should be able to cut costs in pilot populations by 5%.
Managed Care October 2004 John Carroll	DM Industry Jumps for Joy Over Medicare's Leap of Faith The Center for Medicare and Medicaid Services has implemented 10 pilot programs that may very well be viewed as a make-or-break test for disease management.
Managed Care November 2004 Frank Diamond	DM's Cost-Effectiveness Doubted in CBO Report Congress's financial review agency says that not enough evidence exists to prove that disease management saves money. Many beg to differ.
Managed Care June 2002 John Carroll	DM and Medicare: A Marriage Made in Heaven? With a budget of about $230 billion for 40 million patients, many with chronic ailments, is it any wonder that disease management and Medicare are courting?
Managed Care September 2005	There's Now a Correct Method For Defining ROI in Disease Management Health care consultant Al Lewis, the godfather of disease management, talks about how the industry went wrong, and is now going right, in describing its own value to health plans, public employers, and the government.
Managed Care June 2003 Alison Johnson	Measuring DM's Net Effect Is Harder Than You Might Think Disease management is God's gift to managed care. Or is it? Here is a discussion of areas that make evaluating a DM program a complex, if not ineffable, proposition.
Managed Care November 2000 John Carroll	Health Plans Demand Proof That DM Saves Them Money Can disease management vendors really show a strong return on a health plan's investment, or are the data just too malleable to be useful?
Managed Care February 2004 John Carroll	DM Standards Off and Crawling When American Healthways posted a collaborative methodology on its Web site, not everyone in the industry applauded.
Managed Care July 2006 Martin Sipkoff	Employers' Stock in Wellness Rises With No End in Sight Formerly, insurers used to devise new products and processes to attract purchasers. Now more and more employers are going to the plans and insisting on preventive care.
Managed Care September 2000 John Carroll	Mergers, Acquisitions Afoot In Disease Management Industry Within a few years, there may be only 30 DM companies left, says one expert. HMO customers want vendors to handle more than one condition...
Managed Care September 2005	New Research Throws Doubt On DM's Cost-Effectiveness Health plans and other providers of disease management services might do better to emphasize the pursuit of better outcomes, rather than guaranteed savings, a new study implies.
BusinessWeek February 4, 2010 Terhune & Weintraub	Take Your Meds, Exercise -- and Spend Billions Washington wants to pump big money into so-called disease management, though there's scant evidence that it works.
Managed Care January 2001 John Carroll	Florida Leads the Way in Attempting Disease Management for Medicaid Officials across the country are watching to see whether the Sunshine State's innovation can save money...
Managed Care March 2002 John Carroll	DM Vendors Start To Address Costs Created by Comorbidities Some vendors are moving from offering just a few programs to embracing systems that try to deal with all the complicated overlaps...
Managed Care March 2005	'This Country Cannot Continue With the System We Now Have' As a vice president of Pfizer Health Solutions, a major disease management company, John Sory knows how difficult it is to bring systematic care to the chronically ill. He discusses Pfizer's work with Florida's Medicaid program.
Managed Care May 2004 Frank Diamond	Care Coordination Strikes Right Chord Care coordination -- which, for the purposes of this article, means optimal management of people with multiple chronic diseases to improve outcomes and cut costs -- just suddenly seems a lot more doable. The thing that may make care coordination work this time, is technology.
Managed Care August 2007 Frank Diamond	Employers Roll Up Their Sleeves No longer passive, companies are working in a variety of ways to improve employees' care. Preventive programs cost money up front, but can cut overall treatment costs to insurers by 30 percent or more, yet few insurers pay for preventive care.
Managed Care November 1999 Arthur L. Baldwin III	Financial and Risk Considerations for Successful Disease Management Programs Results for disease management programs have not been as positive as hoped because of clinical issues, lack of access to capital, and administrative issues....
Managed Care September 2006 John Carroll	Managed Medicare Revitalized: Feel-Good Plan of the Decade Insurers are largely happy with what they've seen. They're creating new benefit packages and expect more business in the next one to three years.
Managed Care May 2006 Martin Sipkoff	Health Plans Are Ill-Prepared for Looming Diabetes Epidemic The problem is outpacing insurers' resources and perhaps even their commitment. Can the chronic care model help?
Managed Care April 2005 Frank Diamond	Starting Medicare Advantage Plan Brings Special Set of Problems The feds will help you launch a health plan for the elderly, but just what does it take to get something like this operating in so short a time?
Managed Care May 2001 John Carroll	Two Accrediting Organizations Prepare To Issue DM Standards It's probable that one will become the dominant judge: NCQA or URAC. After it happens, will vendors undergo less scrutiny by individual plans?
Pharmaceutical Executive October 1, 2006	Sales and Marketing: Where the Buck Stops Pharma's ultimate customer is the employer - the guy who pays the health plan's bill. Here's what he wants to know about drugs.
Managed Care June 2006	Opinions on DM Outcomes Can Be Swayed An exercise in "point-counterpoint" at a recent disease management meeting showed dramatic swings in views. This shows the managed care industry that there is a great need for civil, structured discussion and honest and respectful public debate of the important issues facing DM.
Managed Care July 2000	NCQA To Accredit DM Programs, HEDIS Software The National Committee for Quality Assurance will soon offer its blessing to disease management programs. NCQA is developing a DM certification program intended to recognize regimens that effectively manage chronic illnesses. The program will go live next year.
Managed Care June 2005 Ed Silverman	It's a Small World After All: Outsourcing Makes Inroads The entire managed care industry is desperate to cut costs and is beginning to turn toward a controversial method to do just that.
Pharmaceutical Executive June 1, 2005 Jill Wechsler	Washington Report: "D" Is for Data It is critical for Medicare to address important questions on drug safety and utilization, and about how prescribing decisions affect health outcomes and costs.
Managed Care September 2004 John Carroll	Pfizer: DM Did Not Fizzle In Florida Medicaid Ruckus Medicaid officials close the books on a program the pharmaceutical giant contends that soon-to-be-released data will verify its disease management program's effectiveness.
Managed Care July 2001 Charles Downey	Disease Management Uses Web To Net Savings More vendors are turning to the Internet to expand the reach of programs. Cutting-edge technology helps patients help themselves...
HBS Working Knowledge July 16, 2008 Porter et al.	What Should Employers do About Health Care? Companies that cut health care costs without improving the overall value of care eventually pay a price in terms of employee absenteeism and chronic ailments.
Managed Care September 2006 David Adler	Pharma Tackles Patient Adherence Drug manufacturers' programs include Web-based reminders, financial incentives, and full-blown disease management
Managed Care October 2001 Michael Levin-Epstein	Medicare Demonstration Projects Seek To Coordinate Chronic Care The Centers for Medicare and Medicaid Services is awaiting the results of landmark demonstration programs to determine if improved Medicare services can be furnished to chronically ill patients without increasing costs...
Managed Care October 2001 Bob Carlson	Trying To Get Control of Drug Costs, Florida Earns Kudos -- and a Lawsuit Pharmaceutical Research and Manufacturers of America (PhRMA) filed suit against Florida's Agency for Health Care Administration, challenging a new Medicaid formulary that requires manufacturers to pay supplemental rebates to have their drugs included...
Managed Care November 1999 Steve Wetzell	To Cure Risk Aversion, Employers Eye Risk Adjustment ...The more employers can get consumers involved in the game, the more providers will become directly accountable to consumers. Under traditional managed care, employers -- without realizing it -- have put themselves in the middle of the relationship between physicians and their patients...
Managed Care November 1999 Uwe Reinhardt, Ph.D.	Defined Contributions Will Point Employees Toward 'Health Marts' Companies will want to distance themselves from insurance entanglements, giving employees little option but to become more involved....
Managed Care March 2005 Frank Diamond	Kaiser's Asthma Outcomes Will Take Your Breath Away The company's Mid-Atlantic States Region has seen impressive savings since launching a disease management program for asthma.
Managed Care November 1999 Al Lewis	Irresistible Force Called DM Facing Some Immovable Objects Disease Management
Managed Care February 2004 John Carroll	New Medicare Risk Adjustments Bad News for Unprepared HMOs Getting less-than-hale elderly enrolled can finally be a sound business strategy for HMOs that comprehend the new rules and have sufficient IT capability.
Managed Care April 2000 Mark D. Abruzzo, J.D.	Despite What You Hear, State Privacy Statutes No Threat to DM In Managed Care's November 1999 issue, Al Lewis, president of the Disease Management Association of America, wrote about potential pitfalls facing DM. One identified by Lewis was state privacy laws, a topic that merits further attention....
Managed Care January 2004	Large Employers Now Use DM To Cut Their Costs Employers are adopting disease management programs in a big way to slow the pace of health care premium increases, according to a survey of 3,000 businesses.
Managed Care October 2001 Stephen Robitaille	Elderly Achieve Better Health When Reporting Vital Signs on Web Patients with heart disease bucked expectations in this study by using the Internet to compensate for their lack of mobility...
Managed Care August 2005 John A. Marcille	Disease Management: Lively Corner of Health Care Disease management is still an area where we're mostly going on faith.