Definition of Disease Management

The Disease Management Association of America (DMAA) defines disease management as a system of coordinated healthcare interventions and communications for populations with conditions in which patient self-care efforts are significant.

Disease management:

• Supports the physician or practitioner/patient relationship and plan of care
• Emphasizes prevention of exacerbations and complications utilizing evidence-based practice guidelines and patient empowerment strategies
• Evaluates clinical, humanistic and economic outcomes on an ongoing basis with the goal of improving overall health¹

The components of a full-service disease management program include:

• Population identification processes
• Evidence-based practice guidelines
• Collaborative practice models to include physician and support-service providers
• Patient self-management education (may include primary prevention, behavior modification programs, and compliance/surveillance)
• Process and outcomes measurement, evaluation, and management
• Routine reporting/feedback loop (may include communication with patient, physician, health plan and ancillary providers, and practice profiling)

Disease Management Goals
There are several critical goals of Disease Management.

• To increase the use of evidence-based care for people with chronic conditions
• To support the control of escalating costs associated with the increasing prevalence of chronic disease
• To help individuals with chronic disease achieve optimal health by
  • Closing the gaps between recommended and actual care (evidence-based medicine)
  • Encouraging patients to adopt a healthy lifestyle (self-efficacy)

Total US Healthcare Expenditures
(billions)

(Source: Centers for Medicare and Medicaid Services, 2005)

US Healthcare Expenditures as Percent of GDP

(Source: Centers for Medicare and Medicaid Services, 2005)

¹Source: Disease Management Association of America, DMAA, www.dmaa.org