Care Management Thoughts
At the recent World Healthcare Congress there was much talk about health plans and care management. In the increasingly competitive payor market differentiation is important, so some insurers are looking to move beyond disease management to “care management.” This focus on member care comes with longer term cost savings that go beyond comparatively simple utilization management.
Executing this care management beyond marketing pabulum requires a combination of new technologies, particularly in the data analytics and evidence based medicine realm, as well as more aggressive communication with members via HRAs, PHRs, clinical content and more health/wellness programs.
Some health plans are doing better than others in particular slices of the care management spectrum, but few have brought it all together in an integrated fashion. While outsourcing certain simple functions such as transaction processing remains an answer for many, the wisdom from WHCC attendees favored a holistic in-house effort to achieve care management.
The risk and reward of care management resides with both insurer and provider, as the specialized networks can gain from pay-for-performance initiatives aligned with different populations.
For the healthcare marketers, consider that the care management topic will be growing in popularity in the media. As more plans and vendors discuss care management, media will seek examples of approaches, tools and end users. This could mean a PR opportunity for you.
Tags: Care+Management, Case+Management, Disease+Management, Healthcare+Outsourcing, Managed+Care, MCO, Utilization+Management
Posted by Shawn Whalen on May 12, 2008 at 2:55 PM
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