FACT:
Numerous plans retain disease managers to help members manage their respective chronic conditions.
PERCEPTION:
Since disease management companies are staffed with medical professionals, such as doctors and nurses, members are getting healthier and plan sponsors are savings money.
REALITY:
Disease management firms are not consistently living up their expectation. In fact, we recently audited a disease manager. While HR Best Practices identified over 300 Type 2 Diabetics, the disease management vendor enrolled less than 10 members in the program. Members were neither getting healthier, nor were their healthcare costs stabilizing.
OPPORTUNITY:
HR Best Practices has proprietary technology to identify and quantify medical and pharmacy costs by the type of chronic condition and reconcile these statistics back to disease management program performance. This same technology can be used to help plan sponsors develop the ROI for disease management program business cases.
