Growth In Disease Management Enrollment Prompts Launch Of New Association

BOSTON—Consumer participation in disease management programs increased an average of 300 percent over the past year, according to board members of the newly-formed Disease Management Association of America (DMAA). The Association, officially launched today, is the first and only association dedicated to educating the health care industry, government, employers and the general public about the important role that disease management programs play in improving health care quality and outcomes for people with chronic conditions such as asthma, congestive heart failure or diabetes. Members of DMAA represent a broad section of the health care industry including health care payers, providers, pharmaceutical companies and disease management organizations.

"Disease management is one of the most important developments in health care delivery to emerge in the last decade," said Al Lewis, president of DMAA's board of directors and executive director of the Disease Management Purchasing Consortium. "Health care payers, providers and even employers are exploring the concept of disease management because they recognize its potential to improve health outcomes across a health plan's or a provider's entire population, as well as lower costs and improve satisfaction with care. However, there is no membership organization dedicated to shaping the industry, setting quality standards and providing a forum in which diverse organizations can convene and learn. The DMAA fulfills this need."

The Association hopes to highlight the value of disease management and encourage the adoption and use of appropriate programs. Outcomes reported by some of the Association's founding members showcase the positive impact of disease management. For example:

• Accordant Health Services, which specializes in managing rare diseases such as hemophilia and lupus, reported a reduction in hospital utilization ranging from 40 percent to 70 percent depending on the condition.
• Albuquerque-based Lovelace Health System's pediatric asthma program reduced lost work days for care givers and decreased lost school days for children by 83 percent.
• In August, The Journal of Clinical Endocrinology and Metabolism published outcomes for participants in Diabetes Treatment Centers of America's (DTCA) population management program. DTCA's program resulted in a 12.3 percent reduction in direct health care costs. In addition, the percentage of participants receiving at least one glycosylated hemoglobin (HbA1c) test rose 124 percent.
• Last year, the peer-reviewed journal Disease Management published the results of Humana Inc.'s congestive heart failure initiative, which is administered by Cardiac Solutions. The program, the largest in the United States, resulted in a 61 percent reduction in inpatient health care costs and a 58 percent decrease in hospital days.
• Patients enrolled in Hartford Hospital's diabetes disease management program reduced their HbA1c levels by an average of 2.1 percentage points. The hospital's asthma control and education program reduced inpatient admissions for patients with asthma by 52 percent.
• Ralin Medical, Inc., through its subsidiary Cardiac Solutions, reported a reduction in medical costs of 52 percent for its heart failure patients and a reduction of more than 30 percent for post-myocardial infarction patients with coronary artery disease.
• Pfizer Health Solution's diabetes disease management program reduced HbA1c levels for participating patients from one academic medical center from a pre-study mean of 10.3 percent to a post-study mean of 8.9 percent. Patients' HbA1c levels decreased further to a mean of 8.2 percent in the six month post-study period.

Lewis explained that while definitions of disease management vary, two common themes emerge across programs. First, disease management results in the provision of more health care services, rather than fewer. Second, effective disease management programs rely on patient data to support physicians in diagnosing, treating and monitoring a patient's disease or condition. Because access to patient data is critical to the success of any disease management program, DMAA plans to take an active role in the patient data confidentiality debate currently before Congress.

"The disease management industry is finally taking off. Health plans' information systems are at the point where patients who would benefit from disease management programs can be identified and outcomes can be reliably improved and those improvements can be measured. Yet, data confidentiality proposals currently being considered by Congress threaten the future success of these initiatives," explained Lewis. "Inappropriate use of personal information—medical or otherwise—is unacceptable. However, use of such information to improve the provision of health care is in the best interests of all stakeholders, the most important of which is the patient."

In addition to ensuring that patient confidentiality legislation supports rather than restricts the provision of health care, DMAA also plans to explore, possibly with the National Committee for Quality Assurance and the American Accreditation Health Care Commission/URAC, the development of disease management program accreditation. The Association also will establish industry guidelines and standards, conduct industry surveys and research and profile member disease management programs and outcomes.

The Disease Management Association of America is professionally staffed and headquartered in Wellesley Hills, Massachusetts. The Association plans to hold its inaugural conference on October 17-20, 1999 at the Grand Hyatt Hotel in San Francisco. For additional information, including A list of DMAA board members and their official statements, plus a copy of the DMAA mission statement, call Wes Harrington, DMAA Executive Director, at 781-895-9078.

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