Managing and Evaluating Healthcare Intervention ProgramsSince its publication in 2008, Managing and Evaluating Healthcare Intervention Programs has become the premier textbook for actuaries and other healthcare professionals interested in the financial performance of healthcare interventions. The second edition updates the prior text with discussion of new programs and outcomes such as ACOs, Bundled Payments and Medication Management, together with new chapters that include Opportunity Analysis, Clinical Foundations, Measurement of Clinical Quality, and use of Propensity Matching. |
Contents
Introduction | 1 |
A Comparative Analysis of Chronic and NonChronic | 15 |
Actuarial Issues in Care Management Evaluations | 81 |
5 | 89 |
1 Causality | 96 |
4 | 112 |
1 | 119 |
Understanding the Economics of Care Management Programs | 163 |
The Use of Propensity Scoring in Program Evaluation | 211 |
An Actuarial Method for Evaluating Care Management Outcomes | 227 |
Random Fluctuations and Validity in Measuring | 269 |
1 Criteria used to Classify Members into Chronic Categories | 291 |
Disease Management Savings Outcomes | 313 |
PART IV | 332 |
Selective Review of the Literature | 353 |
The Relationship Between Health Risk Factors | 371 |
3 | 170 |
1 Calculating Return on Investment | 180 |
Measuring Care Management Savings Outcomes | 197 |
Bibliography | 393 |
161 | 405 |
| 419 | |
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Common terms and phrases
actuaries admissions analysis applied assessment Asthma average baseline period blood Cancer changes Chapter cholesterol chronic condition chronic disease Chronic Measured chronic members chronic population clinical cohort confidence intervals Congestive Heart Failure COPD cost-sharing criteria diabetes diagnosis Disease Management disease management programs DM program drug economic effect eligible employer enrollment estimate evaluation example excluded financial outcomes HbA1c health plan health promotion health risk healthcare Heart Failure hospital identified impact improvement increase inpatient insulin intervention program managed care Measured Population measurement period Medicaid Medicare member months member per month method methodology metric MUGA scan non-chronic trend patients payers Percentage physician PMPM potential predictive model propensity score quality measures randomized reduce regression reported risk adjustment risk factors savings calculation specific Standard Deviations Table target Telehealth Telemedicine therapy Truncation utilization variables worksite