Session 1 of 3-Part Series on New Developments in DM ROI
Overview of Revised Outcomes Measurement Guidelines Published by DMAA: Care Continuum Alliance
Mar 19, 2008
What You'll Learn
In 2005 DMAA: The Care Continuum Alliance committed to a long-term effort to develop consensus-based, outcomes measurement guidelines for programs designed to serve the needs of populations across the entire health care continuum. The first volume of the guidelines, published in fall 2006, was followed by a second volume in September 2007. This presentation focuses on the Volume II guidelines developed through the efforts of DMAA member organizations and external stakeholders in the wellness, disease and care management communities during 2007.
The guidelines presented here fall into five categories: methodology, financial outcomes, selection criteria, clinical effectiveness metrics, and wellness programs. Recommendations discussed include guidelines on trend, risk adjustment, population identification, outliers, small populations and a model illustrating wellness program impact. The presentation will also outline the work underway for 2008.
Each paid registration for this session or the complete 3-Part Series will receive a copy of the revised DMAA Outcomes Guidelines Report-Volume II
Our Speaker
Susan Jennings, MPH, Ph.D.
Consultant on DMAA Outcomes Guidelines Report-Vol.II and Co-Chair of DMAA Outcomes Steering Committee
Susan Jennings, a health care consultant, was Senior Director at Pfizer Health Solutions Inc., a wholly owned care management subsidiary of Pfizer Inc. Dr. Jennings oversaw the work of the evaluation, clinical development, client services and software development teams. She also led PHS’ international programs in the United Kingdom and Italy. Dr. Jennings’ health care background spans over 20 years, and includes serving as Chief Operating Officer of Physician’s Edge, Inc, Senior Vice-President of Value Health Sciences in Santa Monica, and Director at the Health Policy Institute at Boston University. Dr. Jennings has been on the Board of Directors for the DMAA: the Care Continuum Alliance since 2001 and has been co-chair of both the Definitions and Outcomes Steering Committees. Dr. Jennings received her doctorate in sociology from Boston University, an MPH from Yale University, a Masters degree in education from Washington University and a Bachelor of Arts degree from Carleton College.
The Details
Original Webcast: Wednesday, March 19, 2008
Conference CD-ROM: A CD-ROM recording of the entire 3 part series is available for $225 and includes one copy of the revised DMAA Outcomes Guidelines Report-Volume II.
Session 2 of 3-Part Series on New Developments in DM ROI
"What’s New in Disease Management Outcomes Evaluation Methodologies"
Mar 26, 2008
What You'll Learn
The DMAA guidelines call for risk-adjustment of populations to allow for changes in risk-profile in a population over time. When adjusting a non-chronic population to calculate an unbiased trend adjuster, this is not a problem. However, it is difficult to apply traditional risk-adjustment techniques to chronic populations on whom interventions are being performed.
In a study recently submitted to the Journal, Disease Management, we examine alternative methodologies for incorporating risk-adjustment in non-traditional ways into the standard DMAA methodology. We begin with a description of the calculation of trend and the factors that affect it, and then discuss alternative solutions to the chronic risk measurement problem. We illustrate with examples from a Medicaid population.
Attendees will find this a useful refresher on the application of the standard DMAA methodology, particularly the calculation of trend (the biggest single source of observed savings in many studies). You will also have an opportunity to discuss alternative solutions to the risk-adjustment problem.
Our Speakers
Mita Lodh, FSA, PhD
Senior Actuary, schrammraleigh Health Strategy
Mita Lodh is a senior actuary with schrammraleigh Health Strategy (srHS), a consulting group that specializes in health care reform at the state level. Mita is involved in helping with designing options for reducing the number of uninsured persons or implementing mandatory universal coverage in the states that have been among the first to take on the challenge. One among many themes in these large-scale programs is the efficient and effective coordination and management of care for persons with chronic conditions.
Prior to srHS, Mita was the Vice President of Research and Actuarial Services at McKesson Health Solutions (MHS), where she was involved in the design and implementation of contractual methodologies to demonstrate the return on investment of MHS's disease management program. She also oversaw analytics for program monitoring and improvement, as well as publication of cutting-edge research in peer-reviewed journals. Mita’s prior experience includes Mercer and Milliman.
Mita is a Fellow of the Society of Actuaries, Member of the American Academy of Actuaries, and has a Doctorate in Bayesian Statistics from Carnegie Mellon University, Masters in Applied Statistics from Ohio State University, and an MBA in Finance and Information Systems from IIM-A, India.
Ian Duncan, FSA MAAA
President, Solucia Inc.
Mr. Duncan is president of Solucia Inc., a Farmington, CT-based provider of analytical and consulting services to the healthcare financing industry. He has 30 years of experience in healthcare and insurance product design, management, financing, pricing, and delivery. He has started and built consulting practices, and was a founder of a company providing predictive modeling services to managed health insurers and is the only actuary who has actually implemented and managed disease management programs.
Mr. Duncan holds a post-graduate degree in economics from Balliol College, Oxford, and is a fellow of the Society of Actuaries. He serves on the boards of directors of the Commonwealth of Massachusetts Healthcare Connector Authority and the Freelancers Insurance Co. He serves as chair of the Society of Actuaries Healthcare External Relations committee. He is a frequent speaker at industry events, and is the author of numerous papers and books.
The Details
Original Webcast: Wednesday, March 26, 2008
Conference CD-ROM: A CD-ROM recording of the entire 3 part series is available for $225 and includes one copy of the revised DMAA Outcomes Guidelines Report-Volume II.
Session 3 of 3-Part Series on New Developments in DM ROI
"Measuring Disease Management Outcomes in Small Populations"
Apr 2, 2008
What You'll Learn
Random fluctuations in healthcare cost outcomes can cause DM programs to experience unexpected and perplexing variation in claims costs and measured savings. Plan sponsors and DM companies need to know what minimum size of program is required to assure that results are credible. Solucia conducted a comprehensive analysis of factors affecting stability of outcomes, and has designed an approach to credibility assessment that may be applied to any DM program. Attendees at this webcast will learn how to apply this approach to achieve more reliable and credible outcomes analyses.
The session will cover:
- Underlying causes of fluctuations in DM measurement;
- How to estimate minimum group sizes required for confidence in DM results;
- How to place confidence intervals around your estimated savings;
- How to increase credibility of DM measurements in smaller groups;
- How to structure performance guarantees that work.
Our Speaker
Thomas Messer, PhD, ASA, MAAA
Vice President and Chief Actuary, Solucia, Inc.
Tom Messer is a consulting actuary with extensive experience in Disease Management measurement. He recently co-authored "Random Fluctuations and Validity in Measuring Disease Management Effectiveness for Small Populations," currently in review by Disease Management. Tom has over 15 years experience as a health actuary in government, consulting, and health plans. He holds a PhD in mathematics from Duke University.
The Details
Original Webcast: Wednesday, Apr 2, 2008
Conference CD-ROM: A CD-ROM recording of the entire 3 part series is available for $225 and includes one copy of the revised DMAA Outcomes Guidelines Report-Volume II.
If you have any questions, please email us at info@soluciaconsulting.com or call 860-676-8808.
