Health Affairs

Posting date: May 19, 2004

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Health Affairs, 10.1377/hlthaff.w4.281
Copyright © 2004 by Project HOPE

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Perspective: Integrating Disease Management Into The Outpatient Delivery System During And After Managed Care

Victor G. Villagra ^1*

¹ Victor Villagra is president of Health and Technology Vector Inc. in Farmington, Connecticut.

^*Corresponding author.

Abstract

Managed care introduced disease management as a replacement strategy to utilization management. The focus changed from influencing treatment decisions to supporting self-care and compliance. Disease management rendered operational many elements of the chronic care model, but it did so outside the delivery system, thus escaping the financial limitations, cultural barriers, and inertia inherent in effecting radical change from within. Medical management "after managed care" should include the functional and structural integration of disease management with primary care clinics. Such integration would supply the infrastructure that primary care physicians need to coordinate the care of chronically ill patients more effectively.

Key Words: Business of Health, Consumer Issues, Managed Care, Managed Care - Consumers, Managed Care - Physicians, Managed Care - Quality, Insurance Coverage, Quality of Care

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