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HealthLeaders EXTRA!

Evolving benefit designs throw disease management a curveball
Philip Betbeze, May 19, 2005

Call it the kind of managed care that has a shot at success. Had it come of age in an earlier era, disease management might have suffered comparisons with other forms of managed care, which, while achieving the goal of lowering healthcare costs, often failed to deliver quality care, leading some wags to dub it "managed cost."

 Disease management, however, is on the cusp of widespread acceptance among consumers and employers. Under the HMO model, disease management, with its patient-coaching approach, has fully integrated into healthcare, achieving impressive cost-savings milestones for health plans and employers over the last several years, as well as fewer hospital days and better health for patients.....

Philip Betbeze is senior editor of HealthLeaders magazine. He may be reached at philip.betbeze@healthleaders.com

Seven years ago, Thomas D. Kennedy III, president and CEO of Bristol Hospital, decided to flip through some random statistics on Bristol, Conn., from the state department of health. Taking a self-imposed timeout from his usual management headaches, he stumbled across an idea that would fulfill the hospital's community-benefit mandate while simultaneously giving a boost to the area's collective health.

 "Bingo," he says. "It was right there."

"It" referred to statistics showing that the mammography screening rate for women in Bristol was less than 50 percent, compared with about 70 percent statewide. No agency in the area was doing anything about increasing mammography access, "so we did it on our own," says Kennedy. Kicked off in 1998 and seeded with roughly $100,000 from the 120-staffed-bed hospital, the project funds mammography screenings for low-income and uninsured patients. An endowment fund to pay for the screenings was also established and the Bristol Community Breast Health Project Committee, a group of community volunteers, was formed under the hospital's auspices. "If we don't go into this particular void, ain't nobody else gonna do it," Kennedy barks....