Disease Management

Motivated by business pressures, market consolidation, and the pursuit of quality care, health care professionals in all areas of practice are beginning to explore more fully the tremendous potential of disease management-- a systemwide strategy for proactively managing chronic diseases across the entire continuum of care. Disease Management is the first book to bring together systems thinking and organizational structure in a framework for designing, developing, and implementing a comprehensive health management system. List of Figures v

List of Tables ix

About the Editors xi

Contributors xiii

Foreword xix

Senator Bill Frist

Preface xxi

A New Paradigm in Health Care Delivery: Disease Management 1
Mark Zitter

The Disease Management Development Process 27
John H. Eichert, Herbert Wong and David R. Smith

Health Outcomes: Measuring and Maximizing Value in Disease Management 61
John B. Doyle

Financial and Actuarial Issues 87
Richard A. Kipp, W. Charles Towner and Howard A. Levin

Disease State Considerations 137
Charles E. Barr, Daniel L. Bouwman and Frank Lobeck

Clinical Practice Guidelines: Foundation for Effective Disease Management 157
John T. Kelly and David B. Bernard

The Roles of Pharmaceutical Companies in Disease Management 179
Stan Bernard

Disease Management in Managed Care Organizations 207
Joseph E. Biskupiak, Peter Chodoff and David B. Nash

The Role of Case Management in Disease Management 235
Marcia Diane Ward and Julia A. Rieve

Home Care and Disease Management 261
Sharyn S. Lee

Strategic Alliances 281
Warren E. Todd

Beyond Disease Management: Population-Based Health Management 305
Kent W. Peterson and Dennis P. Kane

Index 347

Warren E. Todd is actively involved in disease management and helped engineer an asthma disease management program at the National Jewish Center for Immunology and Respiratory Medicine in Denver. Currently, he serves as vice-president of business development in Hasting Healthcare Group in Pennington, New Jersey.

David B. Nash, MD, nationally recognized for his work in outcomes management, medical staff development, and quality care issues, is the first director of the Office of Health Policy and Clinical Outcomes at Thomas Jefferson University and associate professor of medicine at Jefferson Medical College in Philadelphia. Motivated by business pressures, market consolidation, and the pursuit of quality care, health care professionals in all areas of practice are beginning to explore more fully the tremendous potential of disease management— a systemwide strategy for proactively managing chronic diseases across the entire continuum of care. Disease Management is the first book to bring together systems thinking and organizational structure in a framework for designing, developing, and implementing a comprehensive health management system. "A well-reasoned timely book which will inform the larger health care discussion as we move into the 21st century."
— from the foreword by Senator Bill First