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November 8, 1995

Another Health Care Idea: Disease Management

JAMA. 1995;274(18):1416-1417. doi:10.1001/jama.1995.03530180010003

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MANAGE the disease, not the health care system that handles it. This is the recipe for providing effective, affordable health care, say the proponents of a rapidly burgeoning concept known as disease management.

Their argument is that because the US health care system is highly fragmented, providers and payers view components of care from their own perspective, based on what they deliver or pay for, without regard for optimal care or total cost. Disease management is a strategy largely led by pharmaceutical companies. For a fee that varies with the service provided, the firms that endorse the concept offer to help their customers reduce the total cost of the health care they provide and improve their patients' clinical results.

"Incentives in fee-for-service environments can lead to overutilization of health care resources. At the same time, services in capitated programs can lead to underutilization. We believe a comprehensive, integrated, system-wide approach

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