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Evaluation of four disease management programs: evidence from blue cross blue shield of Louisiana

M Liu1, X Yuan1, J Ouyang1

  • 1Blue Cross Blue Shield of Louisiana, Baton Rouge, LA, USA.

Journal of Medical Economics
|January 29, 2020
PubMed

Insights

New disease management (DM) programs for chronic conditions like diabetes and heart disease proved cost-effective. These programs helped stabilize healthcare costs and showed potential for improved clinical outcomes in patients.

Area of Science:

  • Health Economics
  • Chronic Disease Management
  • Clinical Outcomes Research

Background:

  • Chronic diseases represent a significant financial and clinical burden on healthcare systems.
  • Effective disease management (DM) strategies are crucial for mitigating this impact.
  • This study focuses on DM programs for diabetes, coronary heart disease (CHD)/hypertension (HTN), asthma/chronic obstructive pulmonary disease (COPD), and congestive heart failure (CHF)/chronic kidney disease (CKD).

Purpose of the Study:

  • To evaluate the clinical and economic impact of new DM programs.
  • To assess the cost-effectiveness of DM interventions for major chronic disease groups.
  • To identify trends in per member per month (PMPM) costs and total medical savings.

Main Methods:

  • A comparative study design was used, comparing active DM program enrollees (IN group) with non-enrollees (OUT group).
  • Data were collected from Blue Cross Blue Shield of Louisiana members aged 18-64 between March 2015 and February 2018.
  • Multivariable models and difference-in-difference analysis were employed to compare PMPM costs and calculate medical savings over 1-3 years.

Main Results:

  • Average PMPM costs remained stable for the IN cohort, while increasing for the OUT cohort over time.
  • DM programs demonstrated potential for improving clinical outcomes, such as hemoglobin A1c levels.
  • Significant PMPM savings were observed, reaching $53.72 after 3 years, with total savings exceeding $14.4 million for all programs combined.

Conclusions:

  • Disease management programs for diabetes, CHD/HTN, CHF/CKD, and asthma/COPD are cost-effective.
  • These programs show evidence of improving clinical outcomes.
  • Implementing DM programs offers a viable strategy for managing chronic diseases and reducing healthcare expenditures.

Keywords:
C31Disease managementI13M21chronic diseaseclinical outcomeshealthcare expendituresnurse intervention

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