Health Plans: DM's Struggle to Remain Relevant

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3. Use technology for better self-management
Though the DM industry was built on the nurse call center model, many now suggest there may be more cost-effective ways to improve health.

"The modality used to deal with these people is wrong," says Dacko. "It's a warehouse full of nurses or people working from home, but it's a modality that is a very expensive one to deliver."

There is also the issue of nurses specializing in specific disease states and then needing to transfer patients to other call center staff to help the person with other diseases.

In response, some population health management companies are turning to more cost-effective ways to deliver care. HealthMedia, for instance, has a self-management digital coaching program that looks to empower individuals to take better care of their health through interactive programs that offer a health coach or counselor.

4. Work with docs in the medical home
Disease management has often been seen as an interloper in healthcare.

"I think one of the major weaknesses and the biggest challenges we have had is we have always been outside the doors of the physicians' offices," says Mary Jane Osmick, MD, vice president and medical director at LifeMasters Supported SelfCare Inc. in Irvine, CA.

The industry is trying to change that now by promoting its importance in a medical home model, working with providers to help care for patients in between office visits. This is quite different from the current disease management model, which features DM companies contracting with insurers and employers. But DM advocates think being part of the medical home would show the doctors how DM is valuable to healthcare.

"When physicians, health plans, and disease management companies are fully aligned, the focus will be to support the physician's plan of care and meet the patient needs," says Osmick about the fractured nature of care.

Les Masterson

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