Telephone-Based Chronic Disease Management

Okay, no one has completely given up yet on using various disease management programs, many based on apps or telemedicine.  Research carried in the journal Population Health Management evaluates a telephonic disease management program’s effect on medical spending.  (Pop. Hlth. Article)   The program studied was created by the American Health Data Institute and is utilized primarily by self-funded employers.  It covers 24 common chronic diseases.  People who are candidates for the program are identified by claims data reviews or the results of health risk assessments.  There is initial coaching and education by a nurse with the goal of helping patients learn how to manage their condition more effectively.  Medical costs for a large number of members were examined to determine effects on medical spending.  Note, however, that pharmacy claims were not included, which could be significant, since better medication use and adherence is often a hallmark of a good disease management program.  Members at an employer which purchased the telephone-based disease management assistance were compared with those at an employer which did not.  Somewhat confusingly, participation in the program was deemed to occur if the employer subscribed to it, regardless of how extensively the member actually cooperated with the program.  According to the analysis, participation in the program was associated with a $1158 annual reduction in health expenditures.  It appeared that longer “participation” in the program resulted in greater declines in spending.  But these results were again across all members at the employers who subscribed to the program, not just those who had a chronic disease and really were using the coaching and other services.  So you have to wonder if other factors account for the reduction in spending.