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Disease Specific Program - Case Study Example

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"Disease-Specific Program" paper focuses on disease management that is a system of coordinated health-care interventions and communications for populations with conditions in which patient self-care efforts are significant” as defined by the Disease Management Association of America…
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Disease Specific Program
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Download file to see previous pages The patient could benefit from a build strategy where the insurer directly deals with the consumer or a buying strategy where the insurer secures it from a for-profit organization. Quality is increased and the claims cost is decreased for the patients with diabetes mellitus, asthma, coronary artery disease, and chronic obstructive pulmonary disease (Sidorov, 2006, p. 259). Disease management is widely available in the US.

managed care. Their goals are low annual inflation of costs, elimination of the rising health plan premiums, a value-based competition in health care, and a new concept of incentives for lifetime care against the prevalent insurance for episodic care (Coile, 2000). Transition strategies look towards the Sixth stage for managed care. Health plans, providers, and purchasers need to expand their levels of cooperation to reach that optimal stage. Three insurance companies, Humana, Oxford, and United Healthcare have announced the development of a common physician credentialing application. (Coile, 2000). Administration problems are lessened for doctors and overhead costs are streamlined. The strategies for the Sixth stage may change the health care system and disease management. They are elaborated below contracts with managed care plans. The long terms should be able to have objectives of quality, outcomes, and improvement. Incentives may have to be restructured. Current plans do not give due importance to preventive services and health promotion. Long term agreements could include long term objectives of quality, outcomes, and health improvement. Restructuring of incentives may have to be done to stress upon the long term benefits. Purchasers also may have to think on a long term basis which is not an easy transition. Business is a competition. Mere cooperation to bring about a change to suit policymakers is not the rule (Coile, 2006).

Strategic business relationships help to build voluntary cooperation between providers and health plans. ...Download file to see next pagesRead More
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