Implementation and Outcomes of Commercial Disease Management Programs in the United States: The Disease Management Outcomes Consolidation Survey

Fitzner, Karen; Fox, Kathe; Schmidt, Joseph D.; Roberts, Mark; Rindress, Donna; Hay, Joel W.

doi:10.1089/dis.2005.8.253

Cited by 17 publications

(11 citation statements)

References 25 publications

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“…Recent large-scale evaluations of commercial, outsourced disease management programs found typical telephone counseling services had little impact. 37,38 Yet, several factors may determine effectiveness of an outsourced approach, including who makes the contact, if the service is live or automated, and length, nature and frequency of contacts. [38][39][40][41] It is unclear from our evaluation what explicit attributes of the carve-out method were preferable for patients, and whether these features can explain the better clinical outcomes compared to the carve-in approach.…”

Section: Discussionmentioning

confidence: 99%

Clinic-Based Versus Outsourced Implementation of a Diabetes Health Literacy Intervention

et al. 2013

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BACKGROUND:We compared two implementation approaches for a health literacy diabetes intervention designed for community health centers. METHODS: A quasi-experimental, clinic-randomized evaluation was conducted at six community health centers from rural, suburban, and urban locations in Missouri between August 2008 and January 2010. In all, 486 adult patients with type 2 diabetes mellitus participated. Clinics were set up to implement either: 1) a clinic-based approach that involved practice re-design to routinely provide brief diabetes education and counseling services, set action-plans, and perform follow-up without additional financial resources [CARVE-IN]; or 2) an outsourced approach where clinics referred patients to a telephone-based diabetes educator for the same services [CARVE-OUT]. The fidelity of each intervention was determined by the number of contacts with patients, self-report of services received, and patient satisfaction. Intervention effectiveness was investigated by assessing patient knowledge, self-efficacy, health behaviors, and clinical outcomes. RESULTS: Carve-out patients received on average 4.3 contacts (SD=2.2) from the telephone-based diabetes educator versus 1.7 contacts (SD=2.0) from the clinic nurse in the carve-in arm (p<0.001). They were also more likely to recall setting action plans and rated the process more positively than carve-in patients (p<0.001). Few differences in diabetes knowledge, self-efficacy, or health behaviors were found between the two approaches. However, clinical outcomes did vary in multivariable analyses; carve-out patients had a lower HbA1c (β= −0.31, 95 % CI −0.56 to −0.06, p=0.02), systolic blood pressure (β=−3.65, 95 % CI −6.39 to −0.90, p=0.01), and low-density lipoprotein (LDL) cholesterol (β=−7.96, 95 % CI −10.08 to −5.83, p<0.001) at 6 months. CONCLUSION: An outsourced diabetes education and counseling approach for community health centers

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Section: Discussionmentioning

confidence: 99%

Clinic-Based Versus Outsourced Implementation of a Diabetes Health Literacy Intervention

et al. 2013

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“…Some studies, including randomized trials, identified cost savings [12][13][14][15] while others discovered no cost benefit [16][17][18]. Fitzner et al [19] surveyed 57 commercial disease management programs and found that returns on investment of diabetes and asthma programs range from 0.16:1 to 4:1. Using a "number-needed-to-decrease" analysis, Linden [20] suggested that a disease management program would not break even unless it reduced admissions 10-30% to cover program cost.…”

Section: Cost Savings and Patient Utilizationmentioning

confidence: 99%

Evaluation of chronic disease management on outcomes and cost of care for Medicaid beneficiaries

et al. 2008

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“…7 The specific goals of a particular disease management program may vary, but in the broadest sense, disease management programs provide patient education and support by using evidence-based practice guidelines to prevent complications and improve patients' overall health. This, in turn, reduces unnecessary health care utilization, driving down costs.…”

Section: The Role Of Disease Management In Diabetes Carementioning

confidence: 99%

The Role of Disease Management in Diabetes Care

Benson¹

2010

Diabetes Spectrum

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Implementation and Outcomes of Commercial Disease Management Programs in the United States: The Disease Management Outcomes Consolidation Survey

Cited by 17 publications

References 25 publications

Clinic-Based Versus Outsourced Implementation of a Diabetes Health Literacy Intervention

Clinic-Based Versus Outsourced Implementation of a Diabetes Health Literacy Intervention

Evaluation of chronic disease management on outcomes and cost of care for Medicaid beneficiaries

The Role of Disease Management in Diabetes Care

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