Successful Implementation and Measurement of Disease Management Programs

Humana Case Study

• Best in class strategies to operationalize disease management
• Review the history and breadth of Humana's 7 year investment in disease management
• Demonstrate returns on investment and methodologies to calculate
• Provide a glimpse into the future - consumer directed disease management services

Anthem West Blue Cross and Blue Shield -- Do Disease Management Programs Reduce Health Care Costs? Using a Population-Based Methodology to Rigorously Measure Disease Management Program Outcomes

Disease management is a commonly integrated component of today's managed care programs. While there is general consensus that these programs enhance member quality of life and member satisfaction, there is no consensus that these programs actually reduce the cost of medical care and improve clinical outcomes. Our session will focus on a simple, straightforward but rigorous methodology to calculate plan savings and overall disease management program impact.

• Explanation of regression to the mean and how the population
  based methodology controls for it
• Comparison of this methodology with other savings methodology’s
• Actual health plan results utilizing this methodology
• Clear, simple recommendation for rigorously measuring disease management outcomes.

Jonathan T. Lord, M.D., Senior Vice President and Chief Innovation Officer, Humana, Inc.
Robert S. London, M.D., Vice President of Health Care Management, Anthem West Blue Cross and Blue Shield
David Kreiss, Special Assistant to Administrator, Center for Medicare and Medicaid Services
Walter 'Buzz' Stewart PHD, MPH, Director, Center for Health Research & Rural Advocacy and Director, Outcomes Research Institute, Geisinger Health System