DMAA: The Care Continuum Alliance
Encyclopedia
The Care Continuum Alliance (formerly DMAA: The Care Continuum Alliance) is an industry trade group
Industry trade group
A trade association, also known as an industry trade group, business association or sector association, is an organization founded and funded by businesses that operate in a specific industry...

 of corporations and individuals that "promotes the role of population health
Population health
Population health has been defined as “the health outcomes of a group of individuals, including the distribution of such outcomes within the group.” It is an approach to health that aims to improve the health of an entire population. One major step in achieving this aim is to reduce health...

 improvement in raising the quality of care, improving health outcomes and reducing preventable health care
Health care
Health care is the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in humans. Health care is delivered by practitioners in medicine, chiropractic, dentistry, nursing, pharmacy, allied health, and other care providers...

 costs for individuals with chronic conditions and those at risk for developing chronic conditions". It supports "care continuum services" such as "health
Health promotion
Health promotion has been defined by the World Health Organization's 2005 Bangkok Charter for Health Promotion in a Globalized World as "the process of enabling people to increase control over their health and its determinants, and thereby improve their health"...

 and wellness promotion, disease management
Disease management (health)
Disease management is defined as "a system of coordinated health care interventions and communications for populations with conditions in which patient self-care efforts are significant." For people who can access health care practitioners or peer support it is the process whereby persons with...

, and care coordination" by means of "advocacy, research and the promotion of best practice
Best practice
A best practice is a method or technique that has consistently shown results superior to those achieved with other means, and that is used as a benchmark...

s in care management
Chronic care management
Chronic care management encompasses the oversight and education activities conducted by health care professionals to help patients with chronic diseases and health conditions such as diabetes, high blood pressure, lupus, multiple sclerosis and sleep apnea learn to understand their condition and...

".

Current structure

The Care Continuum Alliance "represents more than 200 corporate and individual stakeholders". Membership categories include:
  • Population health management organizations (e.g., wellness and health promotion
    Health promotion
    Health promotion has been defined by the World Health Organization's 2005 Bangkok Charter for Health Promotion in a Globalized World as "the process of enabling people to increase control over their health and its determinants, and thereby improve their health"...

     organizations; disease and care management
    Chronic care management
    Chronic care management encompasses the oversight and education activities conducted by health care professionals to help patients with chronic diseases and health conditions such as diabetes, high blood pressure, lupus, multiple sclerosis and sleep apnea learn to understand their condition and...

     organizations; home health
    Home care
    Home Care, , is health care or supportive care provided in the patient's home by healthcare professionals Home Care, (also referred to as domiciliary care or social care), is health care or supportive care provided in the patient's home by healthcare professionals Home Care, (also referred to as...

    , nursing home
    Nursing home
    A nursing home, convalescent home, skilled nursing unit , care home, rest home, or old people's home provides a type of care of residents: it is a place of residence for people who require constant nursing care and have significant deficiencies with activities of daily living...

     and elderly care
    Elderly care
    Elderly care or simply eldercare is the fulfillment of the special needs and requirements that are unique to senior citizens. This broad term encompasses such services as assisted living, adult day care, long term care, nursing homes, hospice care, and In-Home care.-Cultural and geographic...

     organizations; behavioral health
    Behavioral health
    In psychology behavioral health, as a general concept, refers to the reciprocal relationship between human behavior, individually or socially, and the well-being of the body, mind, and spirit, whether the latter are considered individually or as an integrated whole...

     organizations; pharmaceutical or biotech organizations; health information technology
    Health information technology
    Health information technology provides the umbrella framework to describe the comprehensive management of health information across computerized systems and its secure exchange between consumers, providers, government and quality entities, and insurers...

     companies; pharmacy benefit managers
    Pharmacy Benefit Management
    In the United States, a Pharmacy Benefit Manager is a third party administrator of prescription drug programs. They are primarily responsible for processing and paying prescription drug claims. They also are responsible for developing and maintaining the formulary, contracting with pharmacies,...

    ; and third party administrator
    Third party administrator
    A Third Party Administrator is an organization that processes insurance claims or certain aspects of employee benefit plans for a separate entity. This can be viewed as "outsourcing" the administration of the claims processing, since the TPA is performing a task traditionally handled by the...

    s)
  • Health plans and integrated delivery systems (e.g., health insurers; health maintenance organization
    Health maintenance organization
    A health maintenance organization is an organization that provides managed care for health insurance contracts in the United States as a liaison with health care providers...

    s; preferred provider organization
    Preferred provider organization
    In health insurance in the United States, a preferred provider organization is a managed care organization of medical doctors, hospitals, and other health care providers who have covenanted with an insurer or a third-party administrator to provide health care at reduced...

    s; Medicare Advantage plans; and Medicaid
    Medicaid
    Medicaid is the United States health program for certain people and families with low incomes and resources. It is a means-tested program that is jointly funded by the state and federal governments, and is managed by the states. People served by Medicaid are U.S. citizens or legal permanent...

     plans)
  • Physician groups and hospitals
  • Partner organizations
  • International organization
    International organization
    An intergovernmental organization, sometimes rendered as an international governmental organization and both abbreviated as IGO, is an organization composed primarily of sovereign states , or of other intergovernmental organizations...

    s
  • Individuals (e.g., government employees; academicians
    Academia
    Academia is the community of students and scholars engaged in higher education and research.-Etymology:The word comes from the akademeia in ancient Greece. Outside the city walls of Athens, the gymnasium was made famous by Plato as a center of learning...

    ; allied health professionals; and full-time students)

The Care Continuum Alliance is governed by a Board of Directors
Board of directors
A board of directors is a body of elected or appointed members who jointly oversee the activities of a company or organization. Other names include board of governors, board of managers, board of regents, board of trustees, and board of visitors...

 and a structure of committees, subcommittees and work groups. The organization maintains a professional staff in Washington, D.C.
Washington, D.C.
Washington, D.C., formally the District of Columbia and commonly referred to as Washington, "the District", or simply D.C., is the capital of the United States. On July 16, 1790, the United States Congress approved the creation of a permanent national capital as permitted by the U.S. Constitution....

, to perform day-to-day administration. In 2008, the Care Continuum Alliance reported that it paid $80,000 in lobbying expenses to Sonnenschein Nath & Rosenthal
Sonnenschein Nath & Rosenthal
Sonnenschein Nath & Rosenthal LLP was an international law firm with nearly 800 lawyers and other professionals in the United States and Europe, serving the needs of many of the world’s best-known businesses, non-profits and individuals. The firm was founded in Chicago in 1906 and as of May 2010...

.

History

The organization was formed in March 1999 as the Disease Management Association of America (DMAA). Its stated purpose was "educating the health care industry, government, employers and the general public about the important role that disease management programs play in improving health care quality and outcomes for people with chronic conditions". The organization's first President was Al Lewis, who described an "irreversible trend toward more disease management" but with some barriers such as state privacy laws.

In early 2003, the Care Continuum Alliance hired Baker, Donelson, Bearman, Caldwell & Berkowitz
Baker, Donelson, Bearman, Caldwell & Berkowitz
Baker, Donelson, Bearman, Caldwell & Berkowitz P.C. is a large U.S. law firm and lobbying group with offices in the Southeastern United States, Washington, D.C. and London, England. According to the National Law Journal's 2010 rankings, it is the 72nd largest law firm in the United States, and...

 to advocate for its interests in the U.S. executive and legislative branches. The Medicare Prescription Drug, Improvement, and Modernization Act
Medicare Prescription Drug, Improvement, and Modernization Act
The Medicare Prescription Drug, Improvement, and Modernization Act is a federal law of the United States, enacted in 2003. It produced the largest overhaul of Medicare in the public health program's 38-year history.The MMA was signed by President George W...

 passed later that year was described as a "major victory" for the Care Continuum Alliance and the firm, in that the law "authoriz[ed] payment for services provided by its [i.e., the Alliance's] members to people with chronic illnesses".

In December 2006, the title of the top position of the Board of Directors changed from "President" to "Chairman," and the chief staff officer's title changed from "Executive Director" to "President and Chief Executive Officer
Chief executive officer
A chief executive officer , managing director , Executive Director for non-profit organizations, or chief executive is the highest-ranking corporate officer or administrator in charge of total management of an organization...

 (CEO)". Tracey Moorhead, the current President and CEO, has been quoted in the newsmedia concerning not only the Care Continuum Alliance but also chronic conditions in general.

As part of a three-year rebranding to its current name, the organization announced a transitional name change ("DMAA: The Care Continuum Alliance") and new mission in September 2007 to reflect the expansion among its membership to services and products along the entire care continuum—from workplace wellness
Workplace wellness
Workplace wellness is a program offered by some employers as a combination of educational, organizational, and environmental activities designed to support behavior conducive to the health of employees in a business and their families...

 and prevention to disease management
Disease management (health)
Disease management is defined as "a system of coordinated health care interventions and communications for populations with conditions in which patient self-care efforts are significant." For people who can access health care practitioners or peer support it is the process whereby persons with...

 and more complex interventions.

Also in 2007, the Care Continuum Alliance redefined this expanded care focus as "population health improvement" and published its "population health improvement model" to document the change.

Outcomes Guidelines Report (2006, 2007, 2008, 2009, 2010)

In recent years, Care Continuum Alliance research activities have focused heavily on measuring outcomes in population-based interventions, such as wellness and care management. These activities were conducted at least partly in response to a 2004 Congressional Budget Office
Congressional Budget Office
The Congressional Budget Office is a federal agency within the legislative branch of the United States government that provides economic data to Congress....

 analysis that concluded that published studies "do not provide a firm basis for concluding that such programs generally reduce total costs".

In 2006, the group initiated a project to build industry consensus on measuring clinical and financial outcomes in wellness and population health management and published the first volume of its oft-cited Outcomes Guidelines Report in December of that year. The usefulness of the first volume was questioned because the guidelines were voluntary in nature and "equivocate[d] on a number of key issues, preventing true standardization even if they were adopted industrywide". In September 2007, the Care Continuum Alliance produced a second volume, with a greater emphasis on clinical outcomes (the first had focused mainly on financial measures). The organization released third and fourth volumes of its guidelines in 2008 and 2009, respectively. Volume 3 continued a "collaboration with NCQA
National Committee for Quality Assurance
The National Committee for Quality Assurance is an independent 501 non-profit organization in the United States designed to improve health care quality. It was established in 1990 with support from the Robert Wood Johnson Foundation. NCQA manages voluntary accreditation programs for individual...

 and other contributors to expand and refine measures in all areas—in particular, methods and measures that allow meaningful comparisons across programs". The Care Continuum Alliance released a fifth volume of the guidelines Oct. 14, 2010, at its 2010 annual meeting, in Washington, D.C.

Population Health Improvement: A Market Survey Report (2010)

This market analysis collected responses from 135 purchasers and providers of health and wellness services and explored a variety of metrics, such as intervention types, use of incentives and measures of success. The analysis also examines market trends, including purchasing expectations, insourcing versus outsourcing of services and use of integrated data platforms. The survey found that 73 percent of purchasers planned to offer population health improvement programs within the 12 months following the survey's release and that 76 percent planned to do so by the end of 2011. Of those already purchasing programs, 84 percent expected additional purchases.

Disease Management and Wellness: Results of a Market Research Survey (2008)

Among other findings, this survey of health plans, employers, and disease management and wellness program providers determined that "84% of health plans and employers offer one or more wellness programs" and that "diabetes, coronary artery disease
Coronary heart disease
Coronary artery disease is the end result of the accumulation of atheromatous plaques within the walls of the coronary arteries that supply the myocardium with oxygen and nutrients. It is sometimes also called coronary heart disease...

 and asthma represent the top three conditions for disease management program enrollment".

Participant Satisfaction Survey (2006)

Developed with support from J. D. Power and Associates, this tool consists of four modules on "access to care, coordination of care, improvements to quality of life
Quality of life
The term quality of life is used to evaluate the general well-being of individuals and societies. The term is used in a wide range of contexts, including the fields of international development, healthcare, and politics. Quality of life should not be confused with the concept of standard of...

 and ability to self-manage chronic conditions". A report prepared for the Agency for Healthcare Research and Quality
Agency for Healthcare Research and Quality
The Agency for Healthcare Research and Quality is a part of the United States Department of Health and Human Services, which supports research designed to improve the outcomes and quality of health care, reduce its costs, address patient safety and medical errors, and broaden access to effective...

 cites the survey tool as a potential measure for patient self-management
Self-management
Self-management means different things in different fields:* In business, education, and psychology, self-management refers to methods, skills, and strategies by which individuals can effectively direct their own activities toward the achievement of objectives, and includes goal setting, decision...

 support programs.

Dictionary of Disease Management Terminology (2004, 2006)

The first (2004) edition of this book defined 126 terms related to disease management. The second edition appeared in 2006.

Media accounts

  • Eisenberg, Daniel (2001-08-20). "Take Your Medicine," Time magazine.
  • Fruedenheim, Milt (2002-02-17). "MONEY & MEDICINE; Bedside Visits, on the Telephone," New York Times.
  • (2002-12-29). "Corporate Corner," St. Paul Pioneer-Press.
  • (2003-09-03) "Cost control quest leads to disease management," Employee Benefit Adviser.
  • Uhlman, Marian (2003-12-29). "Patients' failure to take medicines undermines medical advances," The Philadelphia Inquirer
    The Philadelphia Inquirer
    The Philadelphia Inquirer is a morning daily newspaper that serves the Philadelphia, Pennsylvania, metropolitan area of the United States. The newspaper was founded by John R. Walker and John Norvell in June 1829 as The Pennsylvania Inquirer and is the third-oldest surviving daily newspaper in the...

    .
  • Mulder, James T. (2004-02-08) "Health Works! Employers Take the Lead in Encouraging Wellness and Helping Workers Manage Chronic Disease
    Chronic (medicine)
    A chronic disease is a disease or other human health condition that is persistent or long-lasting in nature. The term chronic is usually applied when the course of the disease lasts for more than three months. Common chronic diseases include asthma, cancer, diabetes and HIV/AIDS.In medicine, the...

    ," The Post-Standard
    Syracuse Post-Standard
    The Post-Standard is the major daily newspaper servicing the greater Syracuse, New York, metro area. Affiliated with Syracuse.com, it is owned by Advance Publications. The Post-Standard features regular political commentary from Sean Kirst and local commentary by Dick Case. It is home-delivered in...

     (Syracuse, N.Y.).
  • Belli, Anne (2004-12-28). "Programs aim to control health-care costs by managing diabetes, other diseases," Houston Chronicle
    Houston Chronicle
    The Houston Chronicle is the largest daily newspaper in Texas, USA, headquartered in the Houston Chronicle Building in Downtown Houston. , it is the ninth-largest newspaper by circulation in the United States...

    .
  • Carroll, John (2004). "DM Standards Off and Crawling," Managed Care magazine.
  • ElBoghdady, Dina (2005-08-02). "A Nurse's Healing Touch, by Telephone; Medicare Program Uses Call Centers," The Washington Post
    The Washington Post
    The Washington Post is Washington, D.C.'s largest newspaper and its oldest still-existing paper, founded in 1877. Located in the capital of the United States, The Post has a particular emphasis on national politics. D.C., Maryland, and Virginia editions are printed for daily circulation...

    , page D-4.
  • Glabman, Maureen (2005). "12 DM Trends You Should Know About," Managed Care magazine.
  • (2006-03-27). "Excellent health benefits help attract, retain top employees," San Diego Business Journal.
  • Glabman, Maureen (2006). "'Take My Word for It': The Enduring Dispute Over Measuring DM's Economic Value," Managed Care magazine.
  • Butler, Kelley (2007-01-05). "Solving a benefits Sudoku," Employee Benefit News.
  • Willett, Hugh G. (2007-04-20). "30 percent of employers offer wellness programs; more planned," Knoxville News-Sentinel
    Knoxville News Sentinel
    The Knoxville News Sentinel is a daily newspaper in Knoxville, Tennessee, USA owned by the E. W. Scripps Company. It operates , an award-winning news website....

    .

External links

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