Capitated chronic disease management programs: a new market for pharmaceutical companies

Article Abstract:

Pharmaceutical companies are carving out a new market for chronic disease management programs. The latter are offered by health maintenance organizations or physician group practices and use disease-specific capitation rates to compensate physicians. A two-year study of an independent practice association with a 53,000-membership is presented to demonstrate the use of a diagnostic cluster methodology to create the capitation system and monitor the program's performance for diabetes mellitus patients.

Author: Cave, Douglas G.
Care and treatment, Research, Pharmaceutical industry, Chronic diseases, Social policy, Diabetes, Diabetes mellitus, Capitated payment systems (Medical care)

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Assessing health plan quality

Article Abstract:

The number of employees who are members of health maintenance organizations (HMOs) is expected to exceed 55 million in 1995. As a result, more and more employers are demanding more information about the quality of health care services and membership satisfaction with HMOs. Formal health plan accreditation and report cards are two tools which could help employers, HMO members and other stakeholders in the healthcare industry to evaluate the quality of services provided by HMOs.

Author: Detmer, Edward J., Ruth, Linda C.
Evaluation, Employee benefits

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Integrated health care management through comprehensive information systems

Article Abstract:

Cost control is the usual motivation for companies to assess their health care plans. However, the relationship between cost-efficient health care and other organizational features demands an integrated assessment approach, which can be facilitated by computer technology. The integrated assessment approach using computer technology helps to account for the effect of cost-efficient health care plans on other parameters such as employee health and productivity.

Author: Henderson, Mary
Health Care and Social Assistance, Medical & Health Services, Occupational health services, Managed care plans (Medical care), Data processing, Electronic data processing

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Subjects list: Management, Usage, Health maintenance organizations, Medical care
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