Regional Hospital Case Study

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Disease management programs are relatively new techniques designed to take care of patients with chronic illnesses. Patients with chronic conditions tend to use more health care services than other patients and the costs associated with these treatments occupy the largest chunk of the health expenditure. There was a study conducted by Johns Hopkins University which showed that the total number of people with chronic illnesses account for 44% whereas their healthcare costs amount for a staggering 78%. (Partnership for Solutions, 2002) Figure 1 – People with Chronic Conditions and their Expenditure
The impacts of these programs will result in decline of hospital readmissions, emergency room visits and even regular healthcare costs.
As the …show more content…
This might be due to many factors such as the follow up after the doctor’s visit or the feedback loop of the medications provided. Regional Hospital is looking for a Disease Management Service which means they want to reduce their utilization rate. In order to reduce utilization costs and to improve patient health outcomes, my strategy and recommendations to contract with a disease management company is in accordance to the guidelines of the Disease Management Association of America (DMAA), that stipulates that a full-service disease management program must include all of the …show more content…
Secondly I would make sure that the patients are involved in a communication loop with Eastern Disease Management (EDM). This would determine whether the patients are taking their meds regularly. The patients will be attracted to enroll in the disease management program with EDM by advocating incentives for the patients. There can also be usage of technology to monitor the daily medication usage of the patients with a track record maintained by EDM.
Since the primary care physicians are the major drivers in healthcare. Incentivizing the primary care doctors would encourage the patients to join these programs at Regional Hospital. Another strategy for promoting disease management would be to reduce copayments for these programs which might help increase the enrollment.
Some other considerations to further cut down cost is considering the savings potential for various diseases like examining whether the prevailing population’s utilization rate compare favorably with national or regional benchmarks and if not,
• How much can this be
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