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Heart failure program proves that DM works--even under fee-for-service
Disease Management Advisor
|September 18, 2002
Summary
Disease management (DM) can improve patient care and financial outcomes in fee-for-service healthcare settings. Implementing DM programs can transform costly diagnoses into profitable services, benefiting both patients and healthcare organizations.
Area of Science:
- Healthcare Management
- Health Economics
- Clinical Operations
Background:
- Healthcare organizations face increasing financial pressures.
- Fee-for-service models are exploring innovative solutions for budget optimization.
- Patient needs must be balanced with financial viability.
Purpose of the Study:
- To evaluate the financial and clinical impact of disease management (DM) in a fee-for-service setting.
- To demonstrate how DM can improve profitability for specific diagnoses.
- To highlight successful implementation of DM programs in integrated health systems.
Main Methods:
- Case study of a large integrated health system in Minnesota.
- Implementation of a disease management program focused on heart failure.
- Analysis of financial and clinical outcomes pre- and post-DM program implementation.
Main Results:
- The disease management program successfully improved care for heart failure patients.
- A previously money-losing diagnosis was transformed into a profitable service.
- The integrated system demonstrated enhanced budget performance through DM.
Conclusions:
- Disease management is a viable strategy for improving financial performance in fee-for-service healthcare.
- Successful DM implementation can optimize resource allocation and enhance patient care.
- Healthcare organizations can leverage DM to meet both budgetary and patient needs effectively.