Reducing Healthcare Cost

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ABSTRACT

REDUCING HEALTHCARE COSTS THROUGH THE IMPLEMENTATION OF

HOSPITAL-GOVERNED DISEASE MANAGEMENT PROGRAMS

Healthcare costs in the United States are on a continual rise with no relief on the horizon. As the population ages and lifestyles differ from one individual to the next, healthcare third party payers such as commercial insurance plans, employee health benefit plans, the Medicare program and state Medicaid programs are searching for strategies to lower the costs associated with providing healthcare benefits to their beneficiaries. Disease management programs are emerging as a way to help decrease the high cost of health care typically associated with chronic illness by coordinating care between the patient and their healthcare provider. By researching how these programs currently being implemented by the third party payer population affect all aspects of a patient’s health, the healthcare industry can learn how to effectively reduce costs for both the patient and the care-providing entities of healthcare. There is a multitude of data; both in the current literature as well as within hospital-specific statistical reports that can be abstracted to prove these programs can be successful. While more research is needed on long-term effects of disease management programs over several years to determine if it does indeed reduce costs and improve the health of the patient, the current research being done is a definite start in the right direction.

TABLE OF CONTENTS

Page
CHAPTER 1 – INTRODUCTION---------------------------------------------------------1
Research Question-------------------------------------------------------------------1
Basis for Study-----------------------------------------------------------------------1
Background---------------------------------------------------------------------------2
Significance of the Study-----------------------------------------------------------3
Hypothesis----------------------------------------------------------------------------4
Definitions----------------------------------------------------------------------------4

CHAPTER 2 – LITERATURE REVIEW--------------------------------------------------5

CHAPTER 3 – METHODOLOGY--------------------------------------------------------12
Population----------------------------------------------------------------------------12
Historical Data-----------------------------------------------------------------------12
Research Plan------------------------------------------------------------------------13

CHAPTER 4 – DATA ANALYSIS AND PRESENTATION OF FINDINGS------15
Data Analysis-------------------------------------------------------------------------15
Overview of Analysis---------------------------------------------------------------16

CHAPTER 5 – SUMMARY, CONCLUSIONS, AND RECOMMENDATIONS--- 18
Summary------------------------------------------------------------------------------- 18
Conclusions---------------------------------------------------------------------------- 19
Recommendations---------------------------------------------------------------------20

REFERENCES--------------------------------------------------------------------------------- 21

BIBLIOGRAPHY------------------------------------------------------------------------------22

CHAPTER I: INTRODUCTION

RESEARCH QUESTION

Can healthcare costs be reduced by hospital governing bodies implementing disease management programs within the hospital setting rather that the third party payer industry implementing these programs?

BASIS FOR STUDY

The majority of studies on disease management and how it can reduce healthcare costs are focused on third party payers such as health maintenance organizations (HMO’s) and state funded Medicaid programs to develop and implement disease management programs. Gillespie and Rossiter (2003) researched three state Medicaid programs that...
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