DMPC Announces Four Payors Earned Savings Certification as Program Receives Increased Validation from Several Sources.
First, four more payors have been awarded DMPC Certification through 2008, the most ever in a single month. Wellmark Blue Cross, Blue Cross and Blue Shield of Florida, Blue Cross & Blue Shield of Rhode Island and the Illinois Department of Healthcare and Family Services join 26 other payors as the only ones to satisfy the requirement of having at least one major disease management financial/utilization measurement technique to be free of known invalidity.
"At Blue Cross & Blue Shield of Rhode Island we understand the value of having an outside agency validate our savings methodology," said Dr. Augustine Manocchia, Chief Medical Officer, Blue Cross & Blue Shield of Rhode Island. "We believe Al Lewis, being the renowned expert and creator of this highly regarded program, has provided the validation necessary so purchasers can now see the value of our disease management programs."
Second, a leading disease management vendor, Health Management Corporation (HMC), a fully-owned subsidiary of Wellpoint, has publicly acknowledged the value of confirming measurement through the DMPC model of plausibility indicators. During the annual conference of the Disease Management Association of America (DMAA), Mark Norton, Director of Clinical Informatics Development for HMC, presented "Corroborating Disease Management Return on Investment Results through Analysis of Plausibility Indicators," in which HMC not only recognized and confirmed DMPC's approach to the technique, but is also pioneering expanding how the method is applied. Likewise, HMC's presentation has prompted DMPC to add alternative plausibility measures to the certification process.
"At HMC, we absolutely support documenting outcomes along a continuum to reinforce financial results," Norton said. "Plausibility indicators are an intuitive way of linking those results to areas that successful programs should influence." HMC's presentation is available on the DMPC website. Notably, if one includes Wellpoint's own members, too, HMC may rank as the nation's largest disease management vendor. DMPC applauds HMC as being the first to study these significant indicators and report on their relevance and future use.
Third, the Disease Management Association of America workgroup on Outcomes Guidelines has added utilization-based indicators to its agenda for 2007, as well as publicly acknowledging in its landmark report the historic contributions of DMPC to the development of measurement standards and certification. The report is available on the DMAA website (www.dmaa.org). At the DMAA's 8th Annual Leadership Forum earlier this month, DMPC CEO Al Lewis participated, along with Esther Emard of the National Committee for Quality Assurance and Dee Eddington of the University of Michigan, on the DMAA Keynote Panel publicly reviewing the guidelines.
Fourth, also at DMAA, Ariel Linden DrPH received the "Best Journal Article" award for "What Will It Take to Show an ROI on Disease Management." This article shows how much the utilization-based plausibility indicators need to "bend" in order to be consistent with certain ROIs. Complementing the intuitive and logical basis, it now forms the major academic support for using utilization-based plausibility indicators to confirm or even roughly measure ROI.
"My goal in writing this article was to make the point and show mathematically that savings need to be validated through utilization reductions," said Linden. "I am pleased that the paper has become part of the DMPC landscape, as well as enshrined as a DMAA award-winner."
Fifth, this month saw the largest-ever RFP from an employer group requiring DMPC certification, from the Minnesota Service Cooperatives, representing roughly 60,000 employees of state and local governments. While it may be a while before this record is broken, this RFP confirms the trend of employers looking for an objective way to validate their outcomes.
About the Disease Management Purchasing Consortium
The Disease Management Purchasing Consortium Int'l, Inc. (DMPC) provides strategy and procurement services to support the disease management and wellness efforts of more than a hundred health plans, employers and states. The DMPC is led by Al Lewis, widely accepted as the founder and most influential leader in the disease management industry. Associate members include national health care accreditation organizations such as JCAHO and URAC, the Harvard School of Public Health, Bain & Co., Boston Consulting Group and McKinsey, and eight investment banks. DMPC also offers Certifications in Savings Measurement Validity, Small Group Outcomes Measurement, and Critical Outcomes Report Analysis. Programs and services are available at www.dismgmt.com.