Disease burden profiles: an emerging tool for managing managed care.
As health plans assume financial risk for providing health care services, effectively managing the health of a population remains one of the toughest challenges. This article shows how risk assessment methods can be used to measure disease burden in the full population and to discriminate levels of future health care needs within specific disease cohorts. We also examine and compare the predictive power of claims-based models within a diabetic cohort.
D002908:Chronic Disease / Q000145:classification / Q000191:economics; D015331:Cohort Studies; D018672:Community Health Planning / Q000191:economics* / Q000706:statistics & numerical data; D003363:Cost Control; D017281:Cost of Illness; D003920:Diabetes Mellitus / Q000191:economics; D003953:Diagnosis-Related Groups / Q000145:classification / Q000191:economics*; D019468:Disease Management; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D007345:Insurance Claim Review; D019458:Insurance Coverage; D007348:Insurance, Health; D008329:Managed Care Programs / Q000191:economics / Q000458:organization & administration* / Q000706:statistics & numerical data; D008484:Medicaid; D015995:Prevalence; D020379:Risk Adjustment; D018570:Risk Assessment / Q000379:methods* / Q000458:organization & administration; D014481:United States / Q000453:epidemiology