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Disease Management. Alice Lind, Office Chief, Division of Program Support, Health & Recovery Services Administration, Department of Social and Health Services, Washington State. Evaluation of Washington State’s outsourced DM program. Original contract terms, vendors The DM-eligible population.
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Disease Management Alice Lind,Office Chief, Division of Program Support, Health & Recovery Services Administration, Department of Social and Health Services, Washington State Evaluation of Washington State’s outsourced DM program
Original contract terms, vendorsThe DM-eligible population • Fee-For-Service: • SSI or SSI related • Aged, Blind or Disabled • TANF children only served in Asthma • Dual eligible Medicare clients not included • No Managed Care clients • About 100,000 clients in population • Estimated 20,000 are eligible for DM • All clients eligible for 24/7 Nurse Advice Line • Chronic conditions of Asthma, Diabetes, HF, COPD, ESRD, CKD • Program is statewide
EvaluationGrading the DM Program • Evaluation metrics included: • Health status • Health processes and outcome indicators • Utilization of medical services • Client satisfaction • Cost savings • No control groups used in enrollment • Evaluation created artificial control groups
University of Washington Independent Evaluation • Significant increase in asthma action plans • Significant increase in eye exams and HgA1c test for diabetics • Increase in ER utilization for three conditions • Drop in high-risk asthma length-of-stay (LOS) in hospital compared to controls. • Lower hospital and ER use by ESRD clients • Patient satisfaction high Note: UW study did not draw conclusions about causal links between DM and observed improvements.
