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Disease management programs: benchmarking costs, savings, ROI

    Healthcare Benchmarks
    |July 6, 1998
    PubMed
    Summary

    Disease management programs are a growing industry driven by demand and cost pressures. Focus on vendor-guaranteed savings, not per-patient fees, for cost-effectiveness, considering factors like patient mix and desired features.

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    Area of Science:

    • Healthcare Management
    • Health Economics
    • Disease Prevention

    Background:

    • The disease management industry is rapidly expanding due to consumer and employer demands, financial pressures, and accreditation requirements.
    • Currently, a centralized, free resource for disease management information is lacking.
    • The industry is fragmented, necessitating careful evaluation of available options.

    Purpose of the Study:

    • To provide guidance on selecting cost-effective disease management vendors.
    • To identify key factors influencing the pricing and value of disease management programs.
    • To assist organizations in navigating the burgeoning disease management market.

    Main Methods:

    • Analysis of expert recommendations on vendor selection criteria.
    • Evaluation of pricing models and cost-effectiveness benchmarks for disease management services.
    • Identification of variables impacting program costs and vendor suitability.

    Main Results:

    • Experts recommend using guaranteed savings as the primary benchmark for evaluating disease management vendors, rather than per-patient fees.
    • Middle- to high-priced vendors often present the most cost-effective solutions.
    • Key cost-influencing factors include patient demographics, the level of risk transferred to the vendor, and the desired program features ('bells and whistles').

    Conclusions:

    • Organizations should prioritize vendors offering demonstrable savings and carefully consider the total cost of ownership.
    • The selection of a disease management vendor requires a nuanced approach, balancing cost with program scope and risk allocation.
    • Strategic vendor selection is crucial for maximizing the return on investment in disease management initiatives.

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