| Value-Added
Benefits
Burden of Disease
Report (BOD)
The Burden of Disease report outlines the clinical
conditions highest in frequency and cost for the Regence
Oregon membership. It is a member-focused initiative
that assures member groups that Regence Oregon is prioritizing
its medical management interventions to address the
conditions that matter most to their needs.
Background:
Regence Oregon is uniquely positioned to offer
the community we serve this integrated and comprehensive
approach to medical management. By having preauthorization,
case management, disease management, health education,
and pharmacy management experts under one roof, we are
able to jointly develop and refine our medical management
activities.
The first step in developing our integrated medical
management strategy is to transform the abundant data
we collect into meaningful clinical information. We
are interested in determining which clinical conditions
occur most often and cost the most among the people
we serve. Those conditions become the primary focus
of our medical management strategies. Regence Oregon
uses a Burden of Disease (BOD) analysis to outline conditions
high in frequency and cost for the entire Regence Oregon
member population. The BOD report is generated on a
regular basis to ensure that medical management activities
are targeted towards our membership’s current
dominant clinical conditions.
Key Findings From the Regence Oregon BOD:
The Regence Oregon BOD report revealed that just four
clinical conditions were responsible for 43 percent
of Regence Oregon costs.
| These four conditions include: |
- Orthopedics
- Cardiology
- Gastroenterology
- Cancer
|
How the BOD is Used:
- The BOD report serves as the strategic compass
for coordinating medical management activities and
ensuring that resources are effectively targeted to
the conditions that matter the most to our members.
- Most individual member groups will have a similar
burden of disease as the overall Regence Oregon burden
of disease. Thus, as Regence Oregon focuses its efforts
on addressing these conditions, it is also responding
to the most important conditions to a majority of
member groups.
- For significant and interested employer groups,
a more focused group BOD analysis called the “Employer
Group Clinical Profile” is created. The profile
examines the demographic and clinical characteristics
of a member group relative to a comparator in order
to identify the specific health issues that drive
the group’s health-care spending. Like the larger
population BOD, an employer group’s BOD is designed
to provide the critical information needed to develop
effective medical management strategies. Contact your
marketing representative for more information.
Examples of BOD Implications:
- The Regence Oregon BOD report highlighted cancer
as one of Regence Oregon’s most clinically burdensome
conditions. As a result, Regence Oregon is now developing
a member-focused cancer case management intervention.
- A clinical profile revealed that orthopedics conditions
were the dominant clinical category for the group.
This information contributed to the group’s
decision to purchase a new array of medical management
services in 2003. This includes a new pilot program,
Back to Health, for addressing back surgery utilization.
The Bottom Line:
Member groups demand maximum value from their health-care
dollar. With a BOD-focused set of interventions in place,
Regence Oregon can effectively address the specific
clinical needs of member groups. Effective medical management
strategies are designed to improve the health status
of members and manage health-care spending.
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