Insurance Education :: Insurers tout disease management programs, but critics are wary

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Released: July 20, 2010

Insurers tout disease management programs, but critics are wary

Source: N.C. Aizenman, Washington Post (Free Registration)

Venante Kotey is a stay-at-home mother in Dumfries. Bridget Hamilton-Roberts is a nurse more than 500 miles away in Atlanta. They’ve never met. But over the past year and a half, Hamilton-Roberts has become critical to Kotey’s health—all through conversations over the telephone.

The two are part of an innovative disease management program that links patients with caregivers across the country. Every week—and sometimes every day—the nurse calls the mom with tips on how to monitor her Type 2 diabetes with blood sugar and lipid tests. She has enrolled Kotey, 35, in free lessons on how to give herself insulin, persuaded her doctor to provide a faster-acting version, and found her a psychiatrist to treat her depression. Hamilton-Roberts has also become a trusted confidante, said Kotey, a person who “really gives me the force to go on. . . . I love Bridget; she is like family.”

These phone-based programs have sparked debate, with critics claiming there is little evidence that they actually work, and proponents—including many insurance companies—lauding them as precisely the sort of prevention-oriented approach needed to fix the health-care system. That debate has gained new salience because of a key requirement of the sweeping health-care overhaul enacted by Congress this year.

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