Cost savings for a preferred provider organization population with multi-condition disease management: evaluating...

Area of Science:

• Health Economics
• Disease Management
• Predictive Modeling

Background:

• Disease management programs often struggle to prove financial value with rigorous statistical methods.
• Employer groups face challenges in demonstrating the ROI of health management initiatives.

Purpose of the Study:

• To evaluate the cost savings of Health Management Corporation's disease management program.
• To assess the financial return on investment for asthma, diabetes, and coronary artery disease management.

Main Methods:

• Utilized a predictive model built from a control group of employer groups not using disease management.
• Compared predicted medical claims costs with actual costs for a study group enrolled in the program.
• Analyzed data from 76,194 members in preferred provider organization health plans.

Main Results:

• The disease management program demonstrated significant gross savings.
• Preliminary analysis indicated a return on investment of $2.84:$1.00.
• Reported $1.45 gross savings per member per month.

Conclusions:

• Health Management Corporation's disease management program shows a positive financial impact.
• The predictive modeling approach provides a statistically rigorous method for evaluating program value.
• Disease management programs can achieve measurable cost savings for employers.