Tag Archives: disease management

Lessons from Medicare

17 Mar

Are disease management, patient education or value based payment cost efficient?

In the medicare experience results were mitigated and barely paid the program’s fees. You can read the brief that has been issued by the  Congressional Budget Office‘s health and Human Resources division:

http://www.cbo.gov/sites/default/files/cbofiles/attachments/01-18-12-MedicareDemoBrief.pdf

and the blog that discusses the report:

http://theincidentaleconomist.com/wordpress/can-the-better-care-lower-cost-act-live-up-to-its-name/

In France  a program of disease management and care coordination has been implemented. Its name is Sophia and it targets two chronic diseases, asthma and diabetes mellitus. More information here:

http://www.ameli-sophia.fr/le-service-sophia

But I can’t find any evaluation of the kind of the CBO report that searches if the health care cost savings, inherent to the program, balance the program’s fees. If you have found such a report let me know.

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how can we appraise Sophia?

23 Jun

A recent post in a medical blog criticized sharply the way the Sophia program of health coaching for tertiary prevention of diabetes melitus was evaluated. In response we can encourage and recognize the effort of evaluation that was already made in them selves and of course we agree the method can be improved. But we must admit that the coaching methods of patient education have already been widely assessed and there are numerous meta analysis on the subject, see for example an Indian paper and an Australian one. Evaluation if any will have to be in an intention to treat design and with random affectation because the respondents to this sort of educational programs differ from non respondents: participants are often in less good health conditions according to the results of an north american survey.

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