CBO Pans Disease Management Program Studies

Many of the studies that attempt to address the effects of disease management programs focus on intermediate measures, such as reductions in the number of return hospital visits, rather than effects on actual costs, Holtz-Eakin adds.

But Holtz-Eakin writes that even the studies that directly look at costs are flawed because they fail to deal with the effects of disease management programs on randomly selected groups of patients.

In the area of diabetes management, for example, “one widely cited study reports lower costs and utilization for patients enrolled in a disease management program at [a health maintenance organization]: $395 per member per month in average paid claims for patients in the program compared with $502 for other patients,” Holtz-Eakin writes. “

But the results of the program may have been biased because participation in the program was optional and the reported savings failed to include the cost of the disease management program, Holtz-Eakin argues.

Another study found that controlling HbA1c levels, an indicator of long-term blood sugar control, can save $685 to $950 per patient per year, but “patients who saw improvements in their HbA1c levels probably differed from other patients who did not in many other ways that would affect their health costs, so the reported results may have little to do with the effects of disease management,” Holtz-Eakin concludes.