The Healthcare Quality Debate: The Case for Disease Management

Abstract

The recent healthcare quality debate is driven primarily by the concern that managed care, in its efforts to cut costs, will jeopardize the quality of care. The debate is complicated by the fact that patients, clinicians, purchasers, and plans define quality differently, resulting in varying evaluations of quality and approaches to quality improvement. Over the past decade, each of these stakeholder groups has announced or implemented many different quality improvement initiatives. Ironically, disease management is rarely mentioned in this debate as a quality improvement approach. Yet, because of its ability to change care delivery, address multiple stakeholder perspectives, demonstrate favorable outcomes, and provide a system for continuous quality improvement, disease management represents our best strategy to enhance the quality of health care in the United States.