Whether CDHPs gain a greater share of the market will depend on what happens in Washington (CDHPs are seen as a Republican solution), as well as whether insurers and employers can actually reduce health costs by empowering—and properly educating—the healthcare consumer.
Questions about DM
Disease management advocates were happy to see 2009 after a difficult year in which CMS ended the DM-inspired Medicare Health Support demonstration project because of disappointing results, and experts questioned whether DM actually reduced costs and improved outcomes.
DM saw its rocky stretches this year too, including LifeMasters Supported SelfCare Inc. filing for bankruptcy in September.
I predicted that 2009 would be a year in which the health industry continued to question DM and it was up to DM to release objective reports about which offerings work best for particular disease states. If DM didn't start this process, I predicted that 2009 could mark the beginning of the end of DM.
The industry studies are still lacking, but employers are also still investing in DM—and the industry is making strides in moving from the old nurse call-center-based model to one that incorporates technology, self-management, member empowerment, and face-to-face interaction when needed.
Chronic care is going to become even more important as more baby boomers move into retirement age. There is a place for DM to flourish in the next 20 years—and those who innovate are the ones who will survive.
There's my look back on 2009, which was an eventful year for healthcare at the national level. I expect the states to get active again in reforms in 2010 and look for ways to bridge gaps left from federal health reform legislation.