Managed Care

Disease Management: Lively Corner of Health Care

John Marcille

Disease management is one of those things that are forever on the verge of something. Year after year, we monitor the ups and downs of this dynamic industry. I say dynamic because no other topic creates such passionate interchange between the editors and writers here, and it is the subject of frequent articles.

Don't get me wrong. When we write about pharmacy utilization, or wconsumer-directed health care, or patient satisfaction, we routinely contact those who are quoted, to assure accuracy and fairness. Often, with these and other topics, there's some heated discussion about just what was said (or wasn't), and what was meant (or wasn't).

However, it's nothing like what happens with disease management. In conversing or corresponding with quoted sources and other experts on a DM article, we usually do not find the restrained analytical tone that experts involved in other articles display.

Sometimes, all heck breaks loose. I have pondered this for most of the years DM has been on the scene. Part of the reason, I believe, is that DM — with its vendors and healthy (I think) obsession with the bottom line — is still an area where we're mostly going on faith, although this is finally changing. Part of it has to do with DM's uncertain future. It's less uncertain now, though: As our cover story points out, CMS has jumped into the DM waters with both feet. That counts for something.

Arthur O'Shaughnessy, quoted by presidents Bush (George W.) and Roosevelt (Franklin D.), wrote in his poem "Ode": "For each age is a dream that is dying, or one that is coming to birth." With the government support, we know a bit more about where the industry fits in the circle of life. Maybe that will calm the waters.

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