THREE MORE PAYORS EARN SAVINGS CERTIFICATION AS PROGRAM RECEIVES INCREASED VALIDATION
Boston, MA – December has brought the Disease Management Purchasing Consortium (DMPC) approach to use of plausibility into the forefront of the field, with five new developments taking place this month. Plausibility is both a concept applied by DMPC generally to check results as well as a specific set of utilization-based indicators available on the DMPC website.
First, three more health plans have been awarded DMPC Certification through 2008, the largest number ever in a single month. Wellmark Blue Cross, BlueCross BlueShield of Florida, and Blue Cross and Blue Shield of Rhode Island join 26 other payors as the only payors to satisfy the requirement of having at least one major disease management financial/utilization measurement technique be free of known invalidity.
Second, a leading disease management vendor has publicly endorsed the value of confirming measurement using the DMPC plausibility indicators. At the Disease Management Association of America, Mark Norton, Director of Clinical Informatics Development at the Health Management Corporation division of Wellpoint, presented "Corroborating Disease Management Return On Investment Results through Analysis of Plausibility Indicators." The presentation had some excellent data as well. Just as DMPC influenced HMC's thinking, HMC's presentation has influenced DMPC to add alternative plausibility measures to the certification process. The paper is available on the DMPC website. If one includes Wellpoint's own members too, HMC is the largest disease management vendor. DMPC applauds their being the first to study these and present on these indicators.
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
Fourth, also at DMAA, Ariel Linden DrPH received the "Best Journal Article" award for "What It 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 was to make the point and show mathematically that savings need to be validated through utilization reductions. 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 we expect it will be a while before this record is broken, this RFP confirms the trend of employers looking for an objective way to validate their outcomes.
Information about DMPC's Savings Measurement Certification Program can be found here.
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.
