Opportunities for administrators to promote disease management.
Studies of disease management (DM) have shown that patients who participate in such programs achieve better health status and make fewer emergency room visits. Private and government payers have recently increased their efforts to promote DM initiatives through financial incentives to healthcare providers. This article explores opportunities for administrators of health services organizations (HSO) to promote DM in the current political and economic environment. Our survey of professionals (DM leaders, physicians, and DM nurses) in six DM programs reveals these professionals' assessments of the key players and resources that they deem important to their respective DM programs. They view DM programs as heavily dependent on the support of physicians, nurses, and health plan leaders but relatively less so on the support of HSO administrators- a situation that may suggest opportunities for administrators to take on greater leadership in moving the HSO toward developing DM programs. Survey results also indicate a strong need for the integration of resources such as communication systems, electronic medical records, and DM reporting. Taken collectively, these needs suggest a number of strategies for the administrator to play a larger role in supporting the adoption and effective implementation of DM. In the article, we propose that DM programs can benefit substantially from an administrator who can demonstrate a thorough knowledge of DM-related government and private-payer initiatives and who has the ability to provide leadership to develop and implement viable DM programs. Valued contributions that the administrator should bring to the table include support of standardized DM processes, use of practice guidelines, and provision of pertinent information systems.
Kash
Bita A
BA
School of Rural Public Health, Texas A&M University System Health Science Center, College Station, Texas, USA. bakash@srph.tamhsc.edu
Gamm
Larry D
LD
Bolin
Jane Nelson
JN
Peck
B Mitchell
BM
D000288:Administrative Personnel; D001291:Attitude of Health Personnel; D014487:Centers for Medicare and Medicaid Services, U.S.; D003625:Data Collection; D004059:Diffusion of Innovation; D019468:Disease Management; D017598:Efficiency, Organizational; D006801:Humans; D007857:Leadership; D009726:Nurses / Q000523:psychology; D010820:Physicians / Q000523:psychology; D010934:Planning Techniques; D016730:Program Development; D012052:Reimbursement, Incentive; D014481:United States