Our healthcare system puts payers in a key position to drive change because they structure the financial incentives that shape provider behavior. In their recently published article, Comprehensive Disease State Modeling Adds Value, which appeared in the March, 2010 issue of Managed Healthcare Executive, authors Michael Abrams, M.A., Managing Partner, and Mark Morgan, M.S.(R), Senior Business Analyst, examine how payers can use disease state modeling to advocate for greater cost effectiveness and differentiate themselves in the market place at the same time.
Disease state modeling is a tool in its infancy, but it offers a data-based method for capturing the impacts of treatment interventions and their costs in a way that facilitates dialogue about more effective care delivery. This opens up considerable potential for payers to offer greater value to customers at lower cost and gain a competitive edge in the process. This article explains why payers can — and should — add disease state modeling to their strategic arsenal.