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

American Journal of Managed Care

Volumn 16, Issue 6, 2010, Pages 438-446

  Dall, Timothy M ^a   Askarinam Wagner, Rachel C ^a   Zhang, Yiduo ^a   Yang, Wenya ^a   Arday, David R ^b   Gantt, Cynthia J ^b,c  

^a LEWIN GROUP   (United States)

^b TRICARE Management Activity   (United States)

^c US Naval Hospital Guam   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

BETA ADRENERGIC RECEPTOR BLOCKING AGENT; CORTICOSTEROID; CROMOGLYCATE DISODIUM; DIPEPTIDYL CARBOXYPEPTIDASE INHIBITOR; LEUKOTRIENE; METHYLXANTHINE; NEDOCROMIL;

ADULT; ARTICLE; ASTHMA; BILLING AND CLAIMS; CONGESTIVE HEART FAILURE; CONSULTATION; CONTROLLED STUDY; DIABETES MELLITUS; FEMALE; HEALTH CARE COST; HEALTH CARE UTILIZATION; HEALTH PROGRAM; HEALTH SERVICE; HEALTH SURVEY; HUMAN; LEARNING; MAJOR CLINICAL STUDY; MALE; MEDICAL INFORMATION; OUTCOME ASSESSMENT; PATIENT SATISFACTION; PREDICTION; PRIORITY JOURNAL; DISEASE MANAGEMENT; ECONOMICS; EVALUATION STUDY; HEALTH INSURANCE; HEALTH SERVICES RESEARCH; HEART FAILURE; INSURANCE; LENGTH OF STAY; MULTIVARIATE ANALYSIS; ORGANIZATION AND MANAGEMENT; PROCEDURES; PROGRAM EVALUATION; PSYCHOLOGY; QUALITY CONTROL; REGRESSION ANALYSIS; SOLDIER; STATISTICS AND NUMERICAL DATA;

ASTHMA; BENCHMARKING; DIABETES MELLITUS; DISEASE MANAGEMENT; HEALTH CARE COSTS; HEALTH SERVICES RESEARCH; HEART FAILURE; HUMANS; INSURANCE CLAIM REPORTING; LENGTH OF STAY; MANAGED CARE PROGRAMS; MILITARY PERSONNEL; MULTIVARIATE ANALYSIS; OUTCOME ASSESSMENT (HEALTH CARE); PATIENT SATISFACTION; PROGRAM EVALUATION; REGRESSION ANALYSIS;

EID: 77954109671     PISSN: 10880224     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Article

References (33)

1. Disease Management Association of America. DMAA Web site. http://www.dmaa.org/. Accessed November 5, 2009.
2. Cousins MS, Liu Y. Cost savings for a preferred provider organization population with multi-condition disease management: evaluating program impact using predictive modeling with a control group. Dis Manag. 2003;6(4):207-217.
3. Fitzner K, Fox K, Schmidt J, Roberts M, Rindress D, Hay J. Implementation and outcomes of commercial disease management programs in the United States: the disease management outcomes consolidation survey. Dis Manag. 2005;8(4):253-264. (Pubitemid 41306630)
4. Goetzel RZ, Ozminkowski RJ, Villagra VG, Duffy J. Return on investment in disease management: a review. Health Care Financ Rev. 2005;26(4):1-19. (Pubitemid 41233632)
5. Krause DS. Economic effectiveness of disease management programs: a meta-analysis. Dis Manag. 2005;8(2):114-134.
6. Wise CG, Bahl V, Mitchell R, West BT, Carli T. Population-based medical and disease management: an evaluation of cost and quality. Dis Manag. 2006;9(1):45-55. (Pubitemid 43306514)
7. Goetzel RZ, Long SRM, Ozminkowski RJP, Hawkins KP, Wang SP, Lynch WP. Health, absence, disability, and presenteeism cost estimates of certain physical and mental health conditions affecting U.S. employers. J Occup Environ Med. 2004;46(4):398-412.
8. Goetzel RZ, Ozminkowski RJP, Baase CMM, Billotti GM. Estimating the return-on-investment from changes in employee health risks on the Dow Chemical Company's health care costs. J Occup Environ Med. 2005;47(8):759-768.
9. Gillespie JL. The value of disease management - part 2: balancing cost and quality in the treatment of diabetes mellitus: an annotated bibliography of studies on the benefits of disease management services for the treatment of diabetes mellitus. Dis Manag. 2002;5(1):37-50.
10. Goetzel RZ. Better outcomes through health and productivity management. Manag Care. 2005;14(10 suppl):28-36.
11. Congressional Budget Office. An Analysis of the Literature on Disease Management Programs. October 13, 2004. http://www.cbo.gov/ftpdocs/59xx/doc5909/ 10-13-DiseaseMngmnt.pdf. Accessed October 26, 2009.
12. Lukacs SL, France EK, Barón AE, Crane LA. Effectiveness of an asthma management program for pediatric members of a large health maintenance organization. Arch Pediatr Adolesc Med. 2002;156(9):872-876.
13. American Association of Health Plans/Health Insurance Association of America. The Cost Savings of Disease Management Programs: Report on a Study of Health Plans. November 2003. http://www.aahp.org/Content/ContentGroups/Homepage- News/DM-Short-Report.doc. Accessed April 28, 2010.
14. Mathematica Policy Research Group. Third Report to Congress on the Evaluation of the Medicare Coordinated Care Demonstration. January 2008. http://www.mathematica-mpr.com/publications/PDFs/Health/MCCD-rptcongress08.pdf. Accessed June 1, 2010.
15. TRICARE Management Activity, Health Program Analysis and Evaluation Directorate (TMA/HPA&E), Office of the Assistant Secretary of Defense (Health Affairs). Evaluation of the TRICARE Program: Fiscal Year 2009 Report to Congress. http://www.tricare.mil/tma/downloads/TRICARE09-4-7-09-full%20size.pdf. Accessed June 1, 2010.
16. Disease Management Association of America. Disease Management Program Evaluation Guide. Washington, DC: Disease Management Association of America; 2004.
17. Standard outcome metrics and evaluation methodology for disease management programs. American Healthways and Johns Hopkins Consensus Conference. Dis Manag. 2003;6(3):121-138.
18. American Diabetes Association. Economic costs of diabetes in the U.S. in 2007. Diabetes Care. 2008;31(3):596-615.
19. Bureau of Labor Statistics. Consumer Price Index - All Urban Consumers. 2009. http://www.bls.gov/data/. Accessed November 5, 2009.
20. American Diabetes Association. Standards of medical care in diabetes - 2008. Diabetes Care. 2008;31(suppl 1):S12-S54.
21. Disease Management Association of America. Participant Satisfaction Survey and Usage Guidelines. Washington, DC: Disease Management Association of America; 2006.
22. National Committee for Quality Assurance. HEDIS 3.0/1998. Vol. 3, Member Satisfaction Survey. Washington, DC: National Committee for Quality Assurance; 1998.
23. Ware JE, Snow KK, Kosinski M, Gandek B. SF-36 Health Survey Manual and Interpretation Guide. Boston, MA: Health Institute, New England Medical Center Hospitals; 1993.
24. Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30(6):473-483.
25. Morton V, Torgerson DJ. Effect of regression to the mean on decision making in health care. BMJ. 2003;326(7398):1083-1084. (Pubitemid 36629731)
26. Tinkelman D, Wilson S. Regression to the mean: a limited issue in disease management programs for chronic obstructive pulmonary disease. Dis Manag. 2008;11(2):103-110. (Pubitemid 351571054)
27. Gmel G, Wicki M, Rehm J, Heeb JL. Estimating regression to the mean and true effects of an intervention in a four-wave panel study. Addiction. 2008;103(1):32-41. (Pubitemid 350233410)
28. Wilson T, Linden A. Asthma disease management: regression to the mean or better? Am J Manag Care. 2005;11(3):136-137.
29. Barnett AG, van der Pols JC, Dobson AJ. Regression to the mean: what it is and how to deal with it. Int J Epidemiol. 2005;34(1):215-220.
30. Beaulieu ND, Cutler DM, Ho KE, Horrigan D, Isham G. The Business Case for Diabetes Disease Management atTwo Managed Care Organizations: A Case Study of HealthPartners and Independent Health Association. Field report. April 2003. Publication number 610. The Commonwealth Fund. http://www.commonwealthfund.org/ usr-doc/beaulieu-bcs-diabetesdiseasemanagement-610.pdf. Accessed April 28, 2010.
31. Snyder JW, Malaskovitz J, Griego J, Persson J, Flatt K. Quality improvement and cost reduction realized by a purchaser through diabetes disease management. Dis Manag. 2003;6(4):233-241. (Pubitemid 38056075)
32. Berg GD, Wadhwa S. Diabetes disease management in a community-based setting. Manag Care. 2002;11(6):42, 45-50.
33. Iannacchione VG. Response probability weight adjustments using logistic regression. Paper presented at: 151st Annual Meeting of the American Statistical Association, Section on Survey Research Methods; August 18-22, 1991; Atlanta, GA.