Disease management programs: program intervention, behavior modification, and dosage effect

Disease management programs provide highly personalized self- management support to consumers afflicted with chronic illnesses. Program interventions include the provision of health information, ongoing motivation, and support for behavior change, adherence to pharmacotherapy, development of self-efficacy, and the distribution of self-care tools. Interactions between program and patients are structured and repetitive over time. Consumer behavior change can result in measurable improvements in quality and medical cost savings from postponement or avoidance of preventable complications. We evaluated the impact on cost and quality of a comprehensive Diabetes Disease Management Program (DDMP) across ten US urban markets. A staggered implementation allowed for ten pre–post and five pair-wise comparisons. The DDMP demonstrated significant improvements in six diabetes-related quality indicators, lower cost, and a dose-response with greater than 6 months participation. We conclude that a DDMP improves quality of care and reduce overall medical costs.     

The new value imperative for privately held companies: The why, what, and how of value management strategy

This discussion describes the why, what, and how of managing for value in privately held companies. Public companies continue to manage for value, a trend that is now pushing its way inexorably into privately held companies. First, we discuss the dynamics that are creating a value-management imperative for these companies. Second, we provide a signaling model to assist management of privately held companies in deciding whether to emphasize (a) revenue growth, (b) the spread between return on invested capital and the weighted average cost of capital, (c) reduction in the cost of capital, or (d) some combination of these three. The key-value-driver model provides guidance in addressing questions such as: Do we have the right to grow? Should we improve profit performance before we grow? What is our performance in relation to our cost of capital? We also describe how to acquire the data necessary to use the model. Third, we present some important but under-utilized tools based upon transactions cost and strategic cost management theories to assist executives in managing for value and discuss when to apply these tools within a strategic context.