Reporter's NotebookDisease-management group looks to larger role

The Disease Management Association of America opened its ninth annual conference with a fresh look and a new message to better reflect its growing membership.

Now known as DMAA: The Care Continuum Alliance, the group aims to help employers, the government and other healthcare purchasers understand and embrace innovative ways to improve the health of Americans, while encouraging strategies that engage consumers in their own health and setting guidelines to measure outcomes of these interventions.

That may sound like a big job, but it’s a necessary one, with healthcare representing 16% of the gross domestic product and 75% of those healthcare dollars going toward treatment of preventable diseases, said Richard Carmona, the former U.S. surgeon general, who delivered the opening keynote on Sunday at Caesar’s Palace in Las Vegas.

“We’re a nation that doesn’t understand health and wellness,” Carmona told the crowd as they munched on sandwich wraps and lemon tarts. “Shame on us as a nation that we need an organization like the DMAA that is doing so many great things.”

Officials at DMAA—now known by its acronym, like the AARP—say the message, name and logo needed to change because of the evolution of this sector of healthcare.

“Our mission is much broader than it once was,” said William Popik, DMAA chairman. “And our membership is also shifting.”

Among the 200 members of DMAA now are quality and accrediting groups, government agencies, large manufacturers, employer groups, physician groups, insurers as well as disease management companies. It is one reason that the annual meeting is growing; this year’s gathering has drawn some 1,200 attendees, up from 1,100 last year.

The next step, Popik said, is to convene a panel of external physician groups to further refine principles and to serve as a basis for action.

In the meantime, the group is moving forward with its mission to provide guidelines so everyone can measure and evaluate disease management programs for their correct worth, said Tracey Moorhead, the group’s president and chief executive officer.

“Understanding how to compare programs is a big problem,” she said.

To that end, the group has developed a toolkit for employers on how best to benefit from disease management interventions and strategies for evaluating them, Moorhead said. This toolkit is available on the group's Web site.

DMAA is also jumping into the presidential campaign. The group is part of the Partnership to Fight Chronic Disease, which is briefing presidential candidates on the importance of incorporating wellness and chronic disease prevention into their healthcare reform plans.

“Our major goal is to make sure affordability is a part of all the candidates’ healthcare reform proposals,” said Ken Thorpe, executive director of the Partnership to Fight Chronic Disease.

Thorpe said that Hillary Rodham Clinton understands this, and also cited Republicans presidential hopefuls Mike Huckabee and Mitt Romney as getting the importance of tackling the obesity epidemic and other treatable chronic conditions to control costs.

Thorpe pointed out that most Americans have health insurance, and nearly all Americans who vote are insured, but many of those people have chronic diseases that are untreated, which leads to higher premiums.

“We’ve got to focus much more attention on how we treat and pay for chronically ill patients,” Thorpe said.

Two industry leaders—John Engler, president and CEO of the National Association of Manufacturers and former governor of Michigan, and Craig Barrett, chairman of Intel Corp.—stressed that the healthcare crisis has been recognized at the upper reaches of the corporate world.

“Even stabilizing costs would be a major win today,” Engler said.

Barrett said change will happen when the people who pay the bills get more involved and when technology becomes more widely adopted.

“How do you get consumer-centric capability in the home to allow people to live better lives?” Barrett asked, adding that home healthcare management could someday be as widespread as desktop digital photography.

Intel’s seminars on the next generation of disease management tools were among the most popular at this year’s conference. But the question on everyone’s mind was: Who would pay for the technology? And where will we get the nurses and other care providers needed to help patients manage their diseases from the comfort of their own homes?

“We need to pull together the evidence of best practice programs to convince Washington that these programs control costs,” Thorpe said.

Physicians can make all the difference in these interventions, said Mark Leavitt, chairman of the Certification Commission for Healthcare Information Technology in a speech. But they must understand and embrace the new technologies. “Paper training is for puppies, not doctors,” Leavitt said.

Rebecca Vesely, based in San Francisco, covers managed care, disease management and pay-for-performance programs. She can be reached at

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