QUALITY: DM has been counting it wrong but Al Lewis sets it straight

Over the last year or so the DM listserv has been buzzing with the concept put about from Al Lewis, Ariel Linden, and Ian Duncan that to this point ROI for disease management programs has been calculated wrongly. But in an interview with Managed Care magazine Al explains how to get it right, and also predicts that this will help DM finally take off.

My cynicism has been detailed — and refuted — before in THCB, but at some point getting DM right will make sense. My fears of course revolve around problem that the the incentive for a insurer to get rid of a sick member is much greater than the incentive for them to manage that member well, and it’s a damn site easier to do the former.

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  1. This is OT for this thread, but I can’t figure out where to put it. I just got an alert that Kaiser is gifting the Watts area of L.A. with free Depression screening:
    This is supposed to be a service for minorities since depression is “under-diagnosed”. However, since a diagnosis of depression can be used to exclude people from individual insurance, including HSAs, doesn’t this amount to an additional burden on minorities? Expanding diagnosis of depression = expand uninsured among minority populations.
    Ps. I also still think there’s a link between SSRIs and obesity, so mass dosing of a problem population (disatisfaction and frustration = depression?) not only keeps them pacified, but may also lower their quality of life and shorten their lifespan.

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