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Disease management contracting: key elements
1Health System Studies, Institute for Research and Education, Park Nicollet Medical Foundation, Minneapolis, Minnesota, USA.
Clinical Therapeutics
|November 1, 1996
Summary
Entering disease management (DM) arrangements requires careful contracting. Pharmaceutical firms and managed care organizations can ensure successful partnerships by focusing on key financial and legal strategies from the outset.
Area of Science:
- Health Services Research
- Pharmaceutical Management
- Managed Care Contracting
Background:
- Disease management (DM) arrangements often begin with incomplete data and developing analytical tools.
- Pharmaceutical firms and managed care organizations (MCOs) face challenges in establishing sound DM partnerships.
- Protecting financial interests and ensuring mutual benefit are critical for early-stage DM collaborations.
Framework:
- Develop comprehensive contracting strategies for DM relationships.
- Incorporate specific financial elements to safeguard economic interests.
- Define key contractual clauses to foster harmonious and profitable partnerships.
Implementation:
- Address concerns for diverse partnership models, including risk-sharing and fee-for-service plans.
- Prioritize early and thorough legal review of DM agreements.
- Establish clear performance metrics and data-sharing protocols.
Implications:
- Proactive legal and financial planning mitigates risks for pharmaceutical firms and MCOs.
- Well-structured DM contracts lead to sustained, successful, and mutually beneficial collaborations.
- Sound contracting practices are essential for long-term viability in the disease management sector.