I got a message today from Richard Citrin, a health and productivity management consultant, who was fresh from this week’s DMAA Care Continuum Alliance Conference. He called the event “excellent,” but did share that “there are some major issues around disease management, not the least is being whether or not DM actually works to improve health and reduce costs, despite common sense and significant research to the contrary.”
Then, he dropped this bombshell on me: “The elephant in the room news was that LifeMasters, a major carveout DM company, declared bankruptcy a few weeks based on the fact that they owe CMS $125 million for failure to achieve ‘guaranteed’ results from work with Medicare populations. The Congressional Budget Office has also reported that DM results may have minimal impact on health care costs.
Despite this clearly not-so-great news, Citrin is remains unbowed about DM’s future. “It is clear that legislators at the federal and national level see DM and health and productivity management programs as key elements of any health care reform and will certainly include them in legislative action at either the national or state level.”
To Citrin’s eye, DM programs “are becoming more sophisticated in terms of [identifying] employees who could benefit from services, the way services are engaging and ‘activating’ employees and how transparency and patient programs are delivered.”
All the same, though, “there continue to be major discussions around outcomes measurements. Personally, when I see ROIs of 3:1, 4:1, 5:1 or 8:1, I really question the plausibility of these kinds of results – and I think so do HR/benefit folks and CFOs. As I tell my clients, ‘If we can achieve an ROI of 1.3:1, we're doing pretty good. Is there anyone who would not accept a 30% return on their 401k?!" Well, if there is, I don’t want to meet them!
Thanks to Citrin for sharing the news and analysis. Comment and let me know what you think about DM’s viability as a cost-savings vehicle for employers and employees.
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