Require that health plans utilize disease management programs

Pilot program includes disease management

Updated: Wednesday, December 2nd, 2009 | By Angie Drobnic Holan

During the presidential campaign, Barack Obama included disease management among his ideas for improving health care and lowering costs. Disease management is intended to improve outcomes for people who have chronic illness. It emphasizes prevention, including enhanced screening, monitoring and education and coordinating care among different health care providers.

Health care reform bills being considered by Congress mention disease management in the context of a pilot program called medical homes. You don't live in a medical homes. They are — sorry for more medical jargon here — primary care practices that emphasize continuous, family-oriented care. Typically, they emphasize prevention through electronic health records, careful tracking of patient outcomes, and superior doctor-patient communication.

The health care bills establish and expand medical homes for Medicare, the national health insurance program for the elderly, and the bills specifically mention disease management as an aspect to be included in the new programs.

A few warnings here: It's not clear that disease management programs save money. And a pilot program is a far cry from all health plans. This promise seems like one more likely to be implemented after other, more significant health care reforms come first. But it is a start. We'll see if the trend spreads. For now, we rate this promise In the Works.

Sources:

U.S. House of Representatives Energy and Commerce Committee, HR 3962 - the Affordable Health Care For America Act

U.S. House of Representatives Ways and Means Committee, HR 3962 - Section by Section

Congressional Budget Office, An Analysis of the Literature on Disease Management Programs , Oct. 13, 2004

The Commonwealth Fund, Can Patient-Centered Medical Homes Transform Health Care Delivery? , March 7, 2009