Stepped Care and E-Health in Behavioral Managed Care
Managed care entities such as Managed Behavioral Health Care Organizations, health plans, and vendors increasingly focus on information technology, e-health, and stepped care in population-based approaches to behavioral health management. Population-based interventions, also known as disease management, involve a systematic approach to defining a population with a chronic illness. In managed care, the population is typically identified based on a combination of claims data showing utilization, diagnoses, medications, and cost of care. Once the population is identified the managed care case manager will outreach individuals and attempt to enroll them in programs designed to improve their ability to effectively manage their chronic condition. The interventions typically include telephonic contacts between the case manager and individual focused on education, monitoring treatment outcome, self-help activities and resources, and treatment adherence.
KeywordsDisease Management Behavioral Health Disease Management Program Chronic Care Model Step Care Model
- Burton WN, Conti D, Chen C. The role of health risk factors and disease on worker productivity. J Occup Environ Med. 1999;4:547–57.Google Scholar
- Kathol R, Clarke D. Rethinking the place of the psyche in health: toward the integration of healthcare systems. Aust N ZJ Psychiatry. 2005;39:826–35.Google Scholar
- Linden A, Adams JL, Roberts N. An assessment of the total population approach for evaluating disease management program effectiveness. Disease Manag. 2003;10:247–51.Google Scholar
- Lynch WD, Chen CY, Bender J, Edington DW. Documenting participation in an employer-sponsored disease management program: selection, exclusion, attrition, and active engagement as possible metrics; 2006.Google Scholar
- Matheson D, Psacharopoulos D, Wilkins A. Realizing the promise of disease management: payer trends and opportunities in the United States. http://www.bcg.com/publications/files/Realizing_the_Promise_of_Disease_Management_Feb06.pdf.; 2006.
- Partnership for Solutions. Chronic Conditions: making the case for ongoing care. Available at: http://www.partnershipforsolutions.org/DMS/files/chronicbook2004.pdf. Accessed February 28, 2009.
- Prochaska JO, Prochaska JM. An update on maximum impact practices from a transtheoretical approach. In: Best Practices in the Behavioral Management of Chronic Disease. Los Altos, CA: Institute for Disease Management; 2005. p. 1–16.Google Scholar
- Prochaska JO, Redding CA, Evers KE. The transtheoretical model of behavior change. In Glanz K,, Lewis FM, Rimer BK, editors. Health behavior and health education: theory, research and practice. 3rd ed. Jossey-Bass; 2008. p. 97–121.Google Scholar
- Wagner EH. What will it take to improve care for chronic illness? Effect Clin Pract. 1998;1:2–4.Google Scholar
- Wagner EH, Davis C, Schaefer J, Von Korff M, Austin B. A survey of leading chronic disease management programs: are they consistent with the literature? J Nurs Care Quality. 2002;16(2):67–80.Google Scholar
- Wu S, Green A. Projection of Chronic Illness Prevalence and Cost Inflation. RAND Health. Sanda Monica, California: RAND Corporation; 2000.Google Scholar