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MICHIGAN STATE UNIVERSITY

Over $1 billion is spent annually for contracted companies to deliver disease management programs to adults with chronic conditions, yet evidence of the effectiveness and cost savings of these programs is lacking. Published research suggests that disease management integrated into a patient's primary health care setting is effective in improving patient outcomes and saving health care dollars. However, a direct comparison of disease management through a health insurance company (i.e., vendor) versus through a primary care practice (i.e., provider) has not been studied. Blue Cross Blue Shield of Michigan (BCBSM), in partnership with 45 practices from five selected physician organizations (POs), will begin implementation of a demonstration project to test provider?]delivered chronic disease care management (PDCM). At the same time, BCBSM will continue to deliver their health plan?]based (e.g., vendor-based model of care) program for their members in practices not in the demonstration project (HPDCM). This research will take advantage of this natural experiment in real world community primary care settings to conduct a comparative effectiveness study of these care management delivery methods for adult patients with one or more of five chronic conditions: asthma, chronic obstructive pulmonary disease, congestive heart failure, coronary artery disease, or diabetes. Using extensive qualitative, quantitative and mixed methods, the researchers will observe, measure, and describe the implementation of PDCM in the intervention practices. Using the Normalization Process Model, the researchers will examine the implementation processes, contexts and environments, and the degree of care management integration to identify best practices for PDCM in primary care. Comparisons of patient outcomes will determine the relative effectiveness of each model of care delivery.

Clarification of Codes