title: Pricing specialty carve-outs and disease management programs under managed care.
abstract: The drive toward improved efficiency and effectiveness in health care has spawned disease management programs to address the needs of patients with certain conditions. These programs parallel traditional case management programs in monitoring patients, but disease management differs from case management in early assessment of patient risk, with proactive clinical interventions and educational efforts. The most comprehensive programs include a coordinated delivery system that can be "carved out" from other health care benefits. Pricing disease management can benefit from the analysis of detailed, disease-specific and community-specific data from public or private sources.
authors.affiliation: Physicians World Communications Group, Secaucus, NJ, USA.
authors.forename: K T
authors.initials: KT
authors.lastname: LaPensee
mesh_terms: D002204:Capitation Fee; D003284:Contract Services; D003361:Cost Allocation / Q000379:methods; D019468:Disease Management; D004470:Economics, Medical; D006801:Humans; D008329:Managed Care Programs / Q000191:economics*; D008495:Medical Oncology / Q000191:economics; D011907:Rate Setting and Review / Q000379:methods; D012308:Risk Management; D013038:Specialization; D014481:United States