Disease Management May Not Cut Health Costs

Article excerpt

Studies of disease management programs fail to provide any conclusive evidence they cut healthcare costs, though the programs may be of value even if they don't, according to the Congressional Budget Office (CBO).

In response to a request by the Senate Budget Committee, the CBO reviewed the literature on disease management to determine whether the programs reduce the overall cost of health care and if they could be used to lower spending by Medicare, the federal healthcare system for seniors. The review found that most of the literature on disease management focuses on processes of care, such as patients' adherence to testing or exam guidelines, or on intermediate measures of health, such as changes in blood pressure or cholesterol levels. The few studies that address healthcare spending generally used controlled settings and failed to account for the additional costs of the programs' screening, monitoring, and educational services.

"The proposition for disease management programs is that better care translates into improved health and, perhaps, to lower-cost care in the future," the CBO report states. "But because the programs directly influence only processes of care, causal links to health outcomes or to economic outcomes may be uncertain or could take several years to become evident."

Disease management programs have become popular in recent years among health plans and organizations seeking to improve the care of patients with chronic diseases (e.g., diabetes and congestive heart failure) and curb the growth of their healthcare costs. …