Managed Healthcare Executive - Disease Management
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Design communication with health literacy in mind
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A recent study by the University of Connecticut indicates that the cost of low health literacy to the
U.S. economy is as high as $238 billion annually. It's imperative that health plans and systems drive new
efforts. (Source: Managed Healthcare Executive - Disease Management)
Source: Managed Healthcare Executive - Disease Management - October 10, 2008 Category: Health Management Source Type: info
Disease registries have flown under clinicians' radar screens
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Disease registries are gaining in popularity as electronic tools designed to give physicians clinical
support to deliver appropriate care. (Source: Managed Healthcare Executive - Disease Management)
Source: Managed Healthcare Executive - Disease Management - September 10, 2008 Category: Health Management Source Type: info
Sleepless nights cost billions in care and productivity
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The continual inability to fall asleep or stay asleep is keeping approximately one-third of the nation
up at night. Individuals with insomnia incur $12 billion in direct medical costs and $2 billion in drug costs
alone. (Source: Managed Healthcare Executive - Disease Management)
Source: Managed Healthcare Executive - Disease Management - August 7, 2008 Category: Health Management Source Type: info
P4P programs aim to track, prevent growing MRSA epidemic
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Methicillin-resistant Staphylococcus aureus (MRSA), a type of bacterium that is resistant to certain
antibiotics, has become a national epidemic, with increasing numbers of serious infections, hospitalizations and
deaths. Hospital stays for these infections tripled from 2000 to 2005. (Source: Managed Healthcare Executive - Disease Management)
Source: Managed Healthcare Executive - Disease Management - July 10, 2008 Category: Health Management Source Type: info
Innovative plan designs focus on consumer engagement, wellness
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The Convergence of Rising healthcare costs, increased cost sharing and demand by consumers for more
participation in healthcare decisions is producing a variety of innovative health insurance solutions. Some of the
new benefit designs focus on consumer engagement and incentives for healthy behaviors, while others are hybrids,
filling a gap between traditional managed care and consumer-directed health plans (CDHP). In some cases, new plan
designs are wrapping a healthy lifestyle component into a high-deductible structure. (Source: Managed Healthcare Executive - Disease Management)
Source: Managed Healthcare Executive - Disease Management - June 9, 2008 Category: Health Management Source Type: info
Attention Leaders in Disease Management: Submit your success stories to Managed Healthcare Executive by June
6!
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Tell us about any leader in disease management, what they've accomplished and how in a few short
bullet points. We'll follow up for more details. (Source: Managed Healthcare Executive - Disease Management)
Source: Managed Healthcare Executive - Disease Management - April 30, 2008 Category: Health Management Source Type: info
Shared decision making gains recognition as patient-centric care model
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The practice of shared decision making (SDM)?the collaboration between patients and caregivers to
arrive at an informed, value-based healthcare decision when treatment options have features that patients value
differently?is gaining recognition among health plans as a key function of a patient-centric model of
care. (Source: Managed Healthcare Executive - Disease Management)
Source: Managed Healthcare Executive - Disease Management - April 10, 2008 Category: Health Management Source Type: info
Shared decision making gains recognition as patient-centric care model
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In september 2007, Kathryn Sabadosa, 41, was diagnosed with the most common kind of non-invasive
breast cancer. The following month, after a mastectomy, the pathology formally diagnosed Sabadosa with stage IIA
breast cancer. (Source: Managed Healthcare Executive - Disease Management)
Source: Managed Healthcare Executive - Disease Management - April 9, 2008 Category: Health Management Source Type: info
Good oral care evolves into new preventive disease tool
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An increasing number of studies are linking oral health to general health. While not establishing a
direct cause-and-effect, the reports show that early prevention and treatment of gum disease could improve outcomes
for pregnancy, heart disease and diabetes. (Source: Managed Healthcare Executive - Disease Management)
Source: Managed Healthcare Executive - Disease Management - March 7, 2008 Category: Health Management Source Type: info
MCOs break the cycle in chronic care with interventions
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Although prevention has become a key element in traditional disease management
programs—trying to prevent or mitigate a chronic disease before it exacerbates—that may
not be sufficient when a patient has a late-stage or end-of-life condition. Americans are living longer: People 65
and older represent 12.4% of the population, and 35% of those older adults are between ages 75 and 84, according
the U.S. Census Bureau. There is a new emphasis on caring for older adults with multiple comorbidities. Almost 80%
of people 65 and older report having a chronic illness, according to the Robert Wood Johns...
Source: Managed Healthcare Executive - Disease Management - February 15, 2008 Category: Health Management Source Type: info
Updated Disease Management Guidelines Impact Investment Perspectives
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Disease management programs don't come cheap, but thanks to industry collaboration, purchasers are
increasingly learning how to assess the business case for these programs. (Source: Managed Healthcare Executive - Disease Management)
Source: Managed Healthcare Executive - Disease Management - January 13, 2008 Category: Health Management Source Type: info
Cost effectiveness can be part of benefit judgments
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For payers struggling with unmanageable cost increases in the business of delivering care, however,
price cannot be overlooked. Insurers don't necessarily deny coverage of a treatment just because it's expensive,
but they would be remiss if they didn't take cost into consideration, as well as safety and
effectiveness. (Source: Managed Healthcare Executive - Disease Management)
Source: Managed Healthcare Executive - Disease Management - December 12, 2007 Category: Health Management Source Type: info
DME coverage guided by medical, regulatory necessity
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As durable medical equipment (dme) becomes increasingly sophisticated, MCOs' challenges remain rooted
in establishing medical necessity. To that end, most use strategies including prior authorization and coverage
limits. Meanwhile, they must also satisfy changing state and national regulatory requirements. (Source: Managed Healthcare Executive - Disease Management)
Source: Managed Healthcare Executive - Disease Management - October 12, 2007 Category: Health Management Source Type: info
Contracts with sports teams a true marketing coup
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IN THE WORLD OF professional sports, the competition isn't only on the gridiron, the court or the
diamond. Just ask an MCO. (Source: Managed Healthcare Executive - Disease Management)
Source: Managed Healthcare Executive - Disease Management - September 7, 2007 Category: Health Management Source Type: info
Chronic care crossroads: AAN CEO hopes to swing policy pendulum in favor of prevention
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PAT FORD-ROEGNER, MSW, RN, FAAN, CEO of the American Academy of Nursing (AAN), seems a natural fit for
her latest appointment as a member of the new Washington, D.C.-based Partnership to Fight Chronic Disease (PFCD)
Advisory Board. The board, led by Richard H. Carmona, MD, MPH, FACS, former U.S. Surgeon General, is comprised of
40 high-profile CEOs and presidents from the public and private sector. (Source: Managed Healthcare Executive - Disease Management)
Source: Managed Healthcare Executive - Disease Management - September 1, 2007 Category: Health Management Source Type: info
Contracts with sports teams a true marketing coup
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IN THE WORLD OF professional sports, the competition isn't only on the gridiron, the court or the
diamond. Just ask an MCO. (Source: Managed Healthcare Executive - Disease Management)
Source: Managed Healthcare Executive - Disease Management - September 1, 2007 Category: Health Management Source Type: info
Men's healthcare concerns don't receive equal attention
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The economics and the politics behind the major healthcare problems affecting men, such as
cardiovascular disease, cancer, obesity and depression, aren't receiving the attention they deserve. It has been
the rule that women make health decisions for themselves and also for their male partners and their children. In
contrast, most men have a more casual attitude toward their care: "if it ain't broke, don't fix
it." That attitude might apply to servicing an automobile but is clearly having a negative effect on the
health and well being of their bodies. (Source: Managed Healthcare Executive - Disease Management)
Source: Managed Healthcare Executive - Disease Management - August 27, 2007 Category: Health Management Source Type: info
Men's healthcare concerns don't receive equal attention
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The economics and the politics behind the major healthcare problems affecting men, such as
cardiovascular disease, cancer, obesity and depression, aren't receiving the attention they deserve. It has been
the rule that women make health decisions for themselves and also for their male partners and their children. In
contrast, most men have a more casual attitude toward their care: "if it ain't broke, don't fix
it." (Source: Managed Healthcare Executive - Disease Management)
Source: Managed Healthcare Executive - Disease Management - August 1, 2007 Category: Health Management Source Type: info
Best practices effective for in-patient heart attack care
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Grace Seems an unlikely acronym for a study of acute coronary events, but given the findings of the
Global Registry of Acute Coronary Events published in the Journal of the American Medical Association, the name may
be apropos. (Source: Managed Healthcare Executive - Disease Management)
Source: Managed Healthcare Executive - Disease Management - July 12, 2007 Category: Health Management Source Type: info
Best practices effective for in-patient heart attack care
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Grace seems an unlikely acronym for a study of acute coronary events, but given the findings of the
Global Registry of Acute Coronary Events published in the Journal of the American Medical Association, the name may
be apropos. (Source: Managed Healthcare Executive - Disease Management)
Source: Managed Healthcare Executive - Disease Management - July 1, 2007 Category: Health Management Source Type: info
Employers reach large populations with progressive DM programs
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Worldwide, 388 million people will die from chronic diseases in the next 10 years. Chronic diseases
account for about 75% of all healthcare costs. Clearly, disease management and prevention is sorely needed, but
it's been a struggle to change the behaviors of large groups of people. A number of programs are finding success
using non-traditional methods. (Source: Managed Healthcare Executive - Disease Management)
Source: Managed Healthcare Executive - Disease Management - June 1, 2007 Category: Health Management Source Type: info
Rheumatoid arthritis takes its place among chronic conditions
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LOW-PREVALENCE rheumatoid arthritis (RA) has not gained attention equal to that of more common chronic
diseases, but it has earned a spot on the list of complex diseases ripe for disease management. (Source: Managed Healthcare Executive - Disease Management)
Source: Managed Healthcare Executive - Disease Management - May 17, 2007 Category: Health Management Source Type: info
New math provides epiphany for measuring ROI
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Disease management as we now define it may be on its last legs, though no one knows it yet. The
Disease Management Purchasing Consortium has noticed that the savings in all but a few diseases doesn't offset the
costs, and nowhere does it generate the level of return on investment (ROI) that some people think they are
getting. (Source: Managed Healthcare Executive - Disease Management)
Source: Managed Healthcare Executive - Disease Management - April 1, 2007 Category: Health Management Source Type: info
Case management for seniors requires heightened coordination
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The centers for Medicare and Medicaid (CMS) says that 23% of Medicare beneficiaries have five or more
chronic conditions but account for 68% of costs—not quite the 80/20 rule. And they tend to see many
different doctors—about 14 a year with almost 40 office visits—and take as many as 10
medications at a time, according to Partnership for Solutions. (Source: Managed Healthcare Executive - Disease Management)
Source: Managed Healthcare Executive - Disease Management - March 1, 2007 Category: Health Management Source Type: info
More on HIV testing (Health Management, Feb. 2007)
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CDC's revised HIV recommendations that all people aged 13 to 64 should have routine HIV testing may be
effective in the public health setting, but might not be as effective in the privat setting, according to one
expert. (Source: Managed Healthcare Executive - Disease Management)
Source: Managed Healthcare Executive - Disease Management - February 1, 2007 Category: Health Management Source Type: info
Revised HIV testing guidelines for adults scrutinized
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Last year acknowledged the 25th year since AIDS was first recognized, and to coincide with that
anniversary, the U.S. Centers for Disease Control and Prevention (CDC) revised its recommendations for HIV testing
for adults, adolescents and pregnant women in healthcare settings. The new guidelines remove the onus of
determining who is at high risk for HIV infection and makes testing a routine part of medical care for all patients
between ages 13 and 64 years. (Source: Managed Healthcare Executive - Disease Management)
Source: Managed Healthcare Executive - Disease Management - February 1, 2007 Category: Health Management Source Type: info
More on HIV testing (Health Management, Feb. 2007)
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CDC's revised HIV recommendations that all people aged 13 to 64 should have routine HIV testing may be
effective in the public health setting, but might not be as effective in the privat setting, according to one
expert. (Source: Managed Healthcare Executive - Disease Management)
Source: Managed Healthcare Executive - Disease Management - February 1, 2007 Category: Health Management Source Type: info
Prenatal ultrasound gathering momentum in disease management
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For more than three decades, clinicians have routinely conducted prenatal ultrasound screenings to
detect congenital anomalies, multiple-gestation pregnancies, fetal growth disorders, placental abnormalities and
errors in the estimation of gestational age. When managed care was born, executives realized the importance of
providing benefit coverage for this test because they recognized prenatal ultrasound is one of the earliest tools
in the disease management arsenal to promote fetal, neonatal, and maternal health. In an era where medical costs
are surging, and in response, healthcare premiums of employers and the...
Source: Managed Healthcare Executive - Disease Management - January 1, 2007 Category: Health Management Source Type: info
States seek enhanced DM for Medicaid patients
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Medicaid Enrolees who suffer from expensive, chronic conditions tend to suffer from so many
comorbidities and complicating social problems—such as homelessness and lack of
transportation—that isolating a single disease state for intervention is ineffective. And states are
beginning to recognize that. (Source: Managed Healthcare Executive - Disease Management)
Source: Managed Healthcare Executive - Disease Management - January 1, 2007 Category: Health Management Source Type: info
Tech tools reduce labor costs for DM programs
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For years, health plans have struggled to achieve one of their primary objectives: the ability to
influence their members' healthcare habits and choices. (Source: Managed Healthcare Executive - Disease Management)
Source: Managed Healthcare Executive - Disease Management - November 28, 2006 Category: Health Management Source Type: info
More on Disease Management (Oct. 2006): Employers weigh in on depression
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Depressive disorders stand out as a major occupational health issue, and employers are feeling the
burden in reduced productivity and higher healthcare costs for their work forces. (Source: Managed Healthcare Executive - Disease Management)
Source: Managed Healthcare Executive - Disease Management - October 10, 2006 Category: Health Management Source Type: info
Depression can be a detriment to workplace productivity
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The times they are a changin'," written and sung by Bob Dylan, was a popular protest song in
the 1960s, and those words hold true today in the dynamic healthcare industry. The American industrial nation bred
musculoskeletal problems but today's workplace presents new problems—depression and related
conditions—the greatest impact on productivity, says Sean Sullivan, president and CEO of the
Institute for Health and Productivity Management in Scottsdale, Ariz., and a member of the Managed Healthcare
Executive editorial advisory board. (Source: Managed Healthcare Executive - Disease Management)
Source: Managed Healthcare Executive - Disease Management - October 10, 2006 Category: Health Management Source Type: info
More on Disease Management (Oct. 2006): Employers weigh in on depression
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Depressive disorders stand out as a major occupational health issue, and employers are feeling the
burden in reduced productivity and higher healthcare costs for their work forces. (Source: Managed Healthcare Executive - Disease Management)
Source: Managed Healthcare Executive - Disease Management - October 1, 2006 Category: Health Management Source Type: info
Depression can be a detriment to workplace productivity
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The times they are a changin'," written and sung by Bob Dylan, was a popular protest song in
the 1960s, and those words hold true today in the dynamic healthcare industry. The American industrial nation bred
musculoskeletal problems but today's workplace presents new problems—depression and related
conditions—the greatest impact on productivity, says Sean Sullivan, president and CEO of the
Institute for Health and Productivity Management in Scottsdale, Ariz., and a member of the Managed Healthcare
Executive editorial advisory board. (Source: Managed Healthcare Executive - Disease Management)
Source: Managed Healthcare Executive - Disease Management - October 1, 2006 Category: Health Management Source Type: info
Single-source DM likely to increase as industry consolidates
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When it comes to health, bigger is not necessarily better. The term "morbid obesity"
has become common vernacular in recent years, even outside of clinics and hospitals. But can bigger mean better
when it comes to finding the best approach to managing DM? Two schools of thought preside in the health plan market
today: Compile a stable of disease-specific vendors and coordinate them in-house (also referred to as
"best-of-breeders"), or choose a single vendor to handle all the disease management
programs. (Source: Managed Healthcare Executive - Disease Management)
Source: Managed Healthcare Executive - Disease Management - September 1, 2006 Category: Health Management Source Type: info
More on health coaching (Disease Management, August 2006)
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The educational and professional qualifications of health coaches is relative to the type of health
coaching that is being done, according to industry experts. (Source: Managed Healthcare Executive - Disease Management)
Source: Managed Healthcare Executive - Disease Management - August 1, 2006 Category: Health Management Source Type: info
In their corner: Health coaches support consumer efforts to alter behavior
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When his daughter was born seven years ago, Dan Schach had been smoking and chewing tobacco for 32
years. He knew then that it was time to make a lifestyle change. (Source: Managed Healthcare Executive - Disease Management)
Source: Managed Healthcare Executive - Disease Management - August 1, 2006 Category: Health Management Source Type: info
Plans take initiative in disaster planning through partnerships (More from Disease Management, July
2006)
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Some health plans are partnering with public health departments and statewide services to develop
disaster plan to help avert the potential catastrophic effects of a flu pandemic. As an integrated delivery system,
SelectHealth in Salt Lake City is working with the Utah Department of Health, which developed the Utah Pandemic
Influenza Response, a preparedness plan in coordination with efforts by WHO and the U.S. Department of Health
& Human Services. The state's primary goals are to minimize serious illness and deaths, societal
disruption and economic loss. (Source: Managed Healthcare Executive - Disease Management)
Source: Managed Healthcare Executive - Disease Management - July 18, 2006 Category: Health Management Source Type: info
Care management and P4P programs face the same challenge: getting physicians to trust and use payer
data
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Care management and pay-for-performance (P4P) programs couldn't be more popular in the industry.
Although often thought of and managed separately, their goals are really the same: to focus attention and dollars
where they will have the greatest impact on patient care. With care management, the focus is on finding and
providing specialized services to those who either have chronic illnesses or who might be heading down the path
toward them. P4P merely casts the net wider with its assumption that tying physician payments to standards of care
will deliver optimal care along the healthcare continuum. (Source: Managed...
Source: Managed Healthcare Executive - Disease Management - July 18, 2006 Category: Health Management Source Type: info
Plans take initiative in disaster planning through partnerships (More from Disease Management, July
2006)
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Discuss or comment on this article.
Some health plans are partnering with public health departments and statewide services to develop
disaster plan to help avert the potential catastrophic effects of a flu pandemic. As an integrated delivery system,
SelectHealth in Salt Lake City is working with the Utah Department of Health, which developed the Utah Pandemic
Influenza Response, a preparedness plan in coordination with efforts by WHO and the U.S. Department of Health
& Human Services. The state's primary goals are to minimize serious illness and deaths, societal
disruption and economic loss. (Source: Managed Healthcare Executive - Disease Management)
Source: Managed Healthcare Executive - Disease Management - July 1, 2006 Category: Health Management Source Type: info
Create a flexible disaster plan to curtail negative impact of pandemic
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Southeasterners dread their hurricanes, Californians remain a bit wary when anything shakes or
rattles, and now many of us are keeping an eye on the possibility of an avian flu pandemic. Although we hear about
its possibility in the news almost daily, most Americans don't seem to be taking any special precautions or
preparing an emergency plan to cope with the H5N1 strain of the avian influenza virus. (Source: Managed Healthcare Executive - Disease Management)
Source: Managed Healthcare Executive - Disease Management - July 1, 2006 Category: Health Management Source Type: info
Care management and P4P programs face the same challenge: getting physicians to trust and use payer
data
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Discuss or comment on this article.
Care management and pay-for-performance (P4P) programs couldn't be more popular in the industry.
Although often thought of and managed separately, their goals are really the same: to focus attention and dollars
where they will have the greatest impact on patient care. With care management, the focus is on finding and
providing specialized services to those who either have chronic illnesses or who might be heading down the path
toward them. P4P merely casts the net wider with its assumption that tying physician payments to standards of care
will deliver optimal care along the healthcare continuum. (Source: Managed...
Source: Managed Healthcare Executive - Disease Management - July 1, 2006 Category: Health Management Source Type: info
Chronic conditions need continual care
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According to the Centers for Disease Control, chronic diseases have become the leading cause of death
and disability in the United States, account for 7 out of every 10 deaths and affect the quality of life of 90
million Americans. In 2002, direct medical costs reached $92 billion and indirect costs (including disability, work
loss and premature mortality) totaled $40 billion. Perhaps the most confounding fact is that although chronic
diseases are among the most common and costly health problems, they also are among the most
preventable. (Source: Managed Healthcare Executive - Disease Management)
Source: Managed Healthcare Executive - Disease Management - June 6, 2006 Category: Health Management Source Type: info
