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A generic model for evaluating payor net cost savings from a disease management program.
1Department of Health Services Research, Management and Policy, University of Florida, Gainesville, Florida, USA.
Journal of Health Care Finance
|November 4, 2008
Summary
This study introduces a model to assess cost savings from disease management programs. It helps evaluate program effectiveness for healthcare payors by analyzing expenditures and operational costs.
Area of Science:
- Health Economics
- Healthcare Management
- Public Health
Background:
- Payors increasingly use disease management programs to enhance care quality and control costs.
- Effective evaluation of these programs is crucial for resource allocation and demonstrating value.
Purpose of the Study:
- To present a generic model for evaluating payor net cost savings from disease management programs.
- To provide a framework for calculating savings, considering both expenditure changes and program costs.
Main Methods:
- The model specifies data requirements and outlines data collection processes.
- Net cost savings are calculated using a spreadsheet-based approach.
- A hypothetical example demonstrates the model's application.
Main Results:
- The model enables comprehensive assessment of financial impact of disease management initiatives.
- It accounts for direct and indirect costs associated with program implementation and operation.
Conclusions:
- The developed model offers a standardized method for payors to evaluate the financial viability of disease management programs.
- This facilitates informed decision-making regarding investment in programs aimed at improving patient outcomes and controlling healthcare spending.
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