Realizing the Promise of Disease Management

This report investigates payer trends in disease management in the United States. All but five of the 120 U.S. payers assessed by a benchmarking study have disease management programs in place. Over 80% of medical and disease management program directors said that senior executives at their firms consider disease management a competitive necessity. Although disease management programs have been widely adopted, no standard methodology exists for measuring cost savings produced by the programs. Growth of disease management programs will come in the short-term through greater offerings to those already covered by insurance.

Long-term growth will come as the programs expand into Medicare and Medicaid populations, and as the field becomes more sophisticated in targeting and supporting patients. Over the long term, payers that integrate disease management into their overall medical management efforts will see the greatest returns in effective care.