Value of Disease Management

Disease Management: Great, Good, Average... Don’t Know

What’s the value of a disease management program? Depends... Too often, disease management, like many newly implemented hospital and healthcare programs, comes about based on a set of identified capabilities that address a known problem. And, their value is most often assessed on a primarily binary scale – that is, the proposed intervention either reduces the cost of care or it does not.  

The challenge in this perspective is that the focus too often shifts to only one outcome and is based on only one course of action. The reality is that managing anyone’s health is a complex and multivariable challenge not really conducive to binary measures. And, in today’s healthcare environment, that is the marketplace, the mix of providers, the intervention by new and evolving technologies and the dynamic of individual patient responses to any other intervention, all sum to create so many inputs and outputs that most people and most organizations simply forego any detailed analysis.  

In reality, all those variables represent the business case for better analysis, not the alternative of “let’s try” or “let’s not.” Healthcare analytics is about more than crunching a bunch of numbers, big data, it is about learning the value of doing so, and about learning the imperative of better decision making in order to try to make healthcare more financially accountable. And, that “more” is in precision, not in quantity.  

The question then is how do you start such an analysis, how do you start in formulating a responsible, factual and workable answer to questions with very complex inputs and large quantities of variables. One answer is Cost Effectiveness Analysis (CEA). CEA allows analysts to combine traditional data, i.e. costs of staff, equipment, facilities and the like with less traditional data, the value of “health,” the cost of patient provider interactions, different interventional costs and values and a virtually limitless set of variables important to yielding a more complete and more accurate data set from which to make decisions.  

We know healthy people use less healthcare and cost the health system less to care for. But, does less cost equal less interaction or perhaps more interactions as varying levels of intensity? Can the concept of a Care Manager who helps a panel of patients navigate the complexities of the healthcare world more efficiently actually pay for herself by reducing major healthcare interactions for her patient base? That’s a question for which CEA can provide answers. And, if you’re a healthcare executive responsible for providing care to a patient population, it’s a question you’re asking.  

If your objective is to provide the best decision-making for your organization and take a global view of your business, expanding your sights beyond ROI, and educating other decision-makers, Cost Effectiveness Analysis can make your organization more competitive and more profitable.

William Matzner, MD. is a recognized expert in Healthcare and Neuro Economics. With a Ph.D. in Economics, MBA and Medical Doctor degree, Dr. William Matzner will provide you with expert analysis on health and wellness programming, populations health management, disease management, new program development, facility development, equipment acquisitions, and other healthcare programs, acquisitions and initiatives. For more information about cost effectiveness analysis and improved financial accountability for your organization, visit Dr. Matzner at