Disease Management Advisor is kicking off a new feature, “Five questions with ... ” this month.
In each issue, we’ll profile an industry leader to get his or her thoughts on the leading issues in DM and population health.
This month, we feature Mack Bryson, CEO of HealthScreen Disease Management in Jacksonville, FL. In 2007, HealthScreen moved from the traditional regional market to a national model. Bryson talks about those experiences and what it takes to go national.
DMA: Describe your company and its offerings.
Bryson: HealthScreen is a fee-based, patient-nurse–centered disease management program.
Our philosophy is that for any disease management program to be successful, there are three basic components that must be achieved:
There must be a behavioral change by the individuals participating in the disease management program
In order for there to be a behavioral change, there must be compliance to treatment and daily care protocols by the individuals participating in the disease management program
In order to accomplish these, there must be active monthly management of the chronically ill
DMA: Why did HealthScreen Disease Management decide to move from the traditional regional market to a national model?
Bryson: Over the years, HealthScreen developed clients that had national exposure.
This, coupled with the fact that we decided to develop a brokerage component, compelled us to create a national strategy in deliverables, as well as marketing capability.
DMA: What does a DM vendor need in order to go national?
Bryson: In order for a DM vendor to expand on a national scope, it is imperative that the program offered be scalable and flexible. This must be accomplished with minimal effort and without compromising the integrity of the core foundations of the disease management program, such as enrollments, incentive structures, case management, etc.
HealthScreen does not utilize a boilerplate mentality in the structure of our programs. We tailor each disease management and/or smoking cessation program to the needs of the client.
DMA: What are the biggest benefits and drawbacks to expanding nationally?
Bryson: The greatest benefits are obvious, with an increase in name recognition, client base, etc. There is an added benefit in the collection of data on a national scope. Through analysis, we can then determine whether certain conditions are more prevalent in specific areas of the country than others.
The most obvious drawbacks would be in the area of logistics. In today’s Internet age, this is less of a problem than it was years ago. As HealthScreen has always utilized personally assigned nurses, we have a substantial database of nurses that are available for our plan participants. We maintain an ongoing national recruitment policy for qualified registered nurses.
DMA: What do you predict for the DM market in the next two or three years?
Bryson: I believe that the disease management industry will play a greater role in addressing the healthcare issues on a national scale. As the awareness of successful disease management programs becomes more commonplace, I believe there will be an increase in the consolidation of these markets. We are already seeing this to some degree.
There also appears to be a movement developing to move away from the capitated pricing models. We are speaking with more and more clients who have experienced dissatisfaction over the lack of performance of these models and are looking for a program that only charges based on those receiving active monthly management and following established treatment and daily care protocols.
Employers are becoming more educated in their expectations of successful disease management programs. They are beginning to realize that it is physically and financially impossible to have a dramatic impact on healthcare costs as relates to the chronically ill for $2 [per employer per month]. The realization is beginning to set in that the most expensive disease management program is the one that does not work.
These employers are now looking at impacts on claims trend, clinical values, utilization, etc. Employers are also realizing that a disease management initiative without a structure for accountability on the part of the participant is at risk for being seen as another entitlement program rather than a true benefit.