Human Resources: Disease Management

What is it?

One strategic program that HR is deploying to support cost reduction efforts is “Disease Management.” Based on the premise that healthy employees are not only happier employees, but also cheaper, disease management is a system of coordinated healthcare interventions and communications for employees with conditions in which patient self-care efforts are significant.

According to recent surveys conducted by the benefits and pharmaceutical industry, about 40 percent of US companies are using some form of disease management. The four most popular “candidates” for disease management coverage are asthma, diabetes, heart disease, and depression, however, some companies are broadening the reach of their programs to include either workplace specific afflictions or a more extensive list of diseases.

What is involved with Disease Management?

Rolling out a disease management program is an intensive process, but has proven returns and cost benefits.

Typical steps in developing a disease management process are:

Identify the target employee population – Through examination of health insurance claims and prescription plans, you should be able to determine the diseases you could cover with the program.

Target disease formalization – Determine the diseases you will actually cover as part of the program – again, the four most common are diabetes, asthma, heart disease, and depression. Comprehensive programs can be extremely expensive, so starting with only those diseases that are likely to produce faster returns is a good idea.

Research evidence-based practices – Determine how you will run the program based on proven best practices gleaned from consultants or industry analysts.

Process and outcomes measurement – Determine exactly how you will communicate and manage the program. Some companies segment the employee population into categories for high risk, medium risk, and low risk and have procedures for managing and communicating with each. For example, a high risk employee receives frequent communication, medical consultation, and monitoring, while a low risk employee may receive periodic e-mails or phone calls advising them of important developments or reminders of prescribed medical examinations.

Process and outcomes measurement – Disease management programs are typically not short term ROI cases, however they should be based on expectations and have measurable factors.

Communication and feedback – Employee participation is critical to the ROI case of disease management. Constant and effective communication on both an employee wide basis and a personal level is critical to the success of the program.

Good disease management programs support physician or practitioner relationships and plan of care, emphasize prevention of exacerbations and complications utilizing evidence-based guidelines and patient empowerment strategies, and evaluate clinical, humanistic, and economic outcomes on an ongoing basis with the goal of improving overall health. With proper identification of the diseases to target in your organization, sound expectations and measurable return identification, a sound communication and feedback plan, and diligent plan management, disease management can have a significant impact on the productivity and overall health cost of employee populations.

What does HR need to know?

Disease management is a cross discipline strategy aimed at improving overall employee health, increasing productivity, and reducing health costs for high risk employees.

Developing a disease management program involves identifying target diseases, outlining processes based on evidence-based practices, and developing a sound communication and feedback framework to support the program.

While not a quick return on investment strategy, the long term benefits of disease management can be quite lucrative (in terms on both cost savings and employee population health).

For more information, visit www.dmaa.org – the Disease Management Association of America.