Success hinges on managing population
Help the acute patient; don’t let well get sick
The underlying philosophy behind Nashville, TN-based Diabetes Treatment Centers of America’s NetCare program is to treat the entire diabetic population, not just to concentrate on the "frequent flyers," says Robert Stone, executive vice president.
"One of the things that we have discovered about diabetes over the years is that if you only manage the high-risk patients, you are dooming yourself to disaster," Stone says. "The reason for that is that 80% of next year’s high-risk population is not this year’s high-risk population. So if you only focus on the very tip of the iceberg, so to speak, you make no long-term progress against avoiding people becoming sicker."
Look beyond the sicker patients
Stone sees the propensity among disease management programs to concentrate on the sickest patients as an industrywide problem that must be overcome. Yes, there is significant financial opportunity in emphasizing care for the sickest, but emphasizing that care to the exclusion of managing the rest of the population is self-defeating, he maintains.
"So our operating and value proposition is significantly different from what anybody else is going to find out there for pretty much any disease because we are responsible not only for the entire population with diabetes in a plan, but we are responsible for managing and integrating their interactions with the entire health care system, irrespective of what the reason for that interaction is," Stone maintains. "So when a member with diabetes has an auto accident and ends up in the ER with a broken leg, that’s our problem to manage."
[For more information, contact Robert E. Stone, executive vice president, Diabetes Treatment Centers of American, One Burton Hills Blvd., Nashville, TN 37215. Telephone: (615) 665-7760; e-mail: [email protected].]
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