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Related Experiment Videos

Outcomes and lessons learned from evaluating TRICARE's disease management programs.

Timothy M Dall¹, Rachel C Askarinam Wagner, Yiduo Zhang

¹The Lewin Group, Falls Church, VA 22042, USA. tim.dall@lewin.com

The American Journal of Managed Care

|June 22, 2010

Summary

Disease management programs for asthma, congestive heart failure, and diabetes improved patient outcomes and reduced costs, offering a positive return on investment. Lessons learned can guide future program development and evaluation.

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Area of Science:

Health Services Research
Chronic Disease Management
Healthcare Economics

Background:

Disease management (DM) programs are increasingly implemented to improve care for chronic conditions.
TRICARE, a health program for U.S. military personnel and families, offers DM programs for asthma, congestive heart failure (CHF), and diabetes.

Purpose of the Study:

To evaluate the outcomes and lessons learned from TRICARE's DM programs for asthma, CHF, and diabetes.
To assess the impact of DM programs on healthcare utilization, costs, and clinical outcomes.

Main Methods:

A multiyear evaluation of voluntary, opt-out DM programs involving 23,793 asthma, 4092 CHF, and 29,604 diabetes patients.
Analysis of medical claims using multivariate regression with historical controls to determine program effects.
Patient surveys to assess satisfaction and perceived usefulness of program services.

Main Results:

DM programs demonstrated modest improvements in patient outcomes, including reduced inpatient days and medical costs.
Annual per-patient cost reductions were $453 (asthma), $371 (CHF), and $783 (diabetes).
The estimated return on investment for DM services was $1.26 for every $1.00 spent.

Conclusions:

TRICARE's DM programs are cost-effective, generating a positive return on investment while improving patient health and quality of life.
Lessons learned from program design, implementation, and evaluation can inform other organizations considering DM initiatives.