MONITORING THE SUCCESS OF EXISTING HEALTHCARE PROGRAMS


William Matzner, MD
Dr. William Matzner, Simi Valley, California

In the modern days of limited healthcare resources and decreased insurance reimbursements, it is not only helpful for healthcare organizations to analyze how new programs affect them economically, but also very useful to monitor the economic outcome of existing healthcare programs or treatments.

I was asked to analyze an existing disease management program by a large healthcare organization. They had developed a disease management program for COPD and wished to know if it was economically sound to continue this program.

I concluded that the most thorough way to evaluate this program was to use a Cost Effectiveness Markov Model. These models are excellent for looking at chronic on going conditions such as COPD. There are three possible disease states: Stable, somewhat sick and visiting urgent care, very sick and requiring hospitalization.

We were able to calculate not only costs associated with each state but also the quality of life as expressed in quality adjusted life years (QALY). The program was analyzed using incremental cost effectiveness ratio (ICER). 

The conclusion was that the program was successful by a significant amount, and furthermore that the savings was due to significant cost decrease in hospitalization of COPD patients involved in the program. Thus CEA can not only evaluate existing programs, but guide us into how those programs prove their effectiveness. CEA is starting to show its increased versatility in the modern healthcare economic environment. 

About William L. Matzner, M.D., PhD, FACP 

Dr. William Matzner works in the area of healthcare economics consulting at Healthcare Analytics, LLC, in California. He graduated Phi Beta Kappa from Stanford University. He received his M.D. with Honors from Baylor College of Medicine. In 1988, he was the Solomon Scholar for Resident Research at Cedar Sinai Medical Center. Dr. Matzner subsequently was awarded a PhD in Neuro Economics from Claremont Graduate University. He is board certified in Internal Medicine and Palliative Medicine. He has researched and published extensively on the issue of reproduction and immunology in medical literature. He has been in private practice since 1989, specializing in Reproductive Immunology and Internal medicine. 

Consulting Website: https://healthcareanalytics.biz 
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William Matzner, MD (Simi Valley, California), has been practicing medicine since 1989, Internal Medicine and Reproductive Immunology. M.D. with Honors from Baylor College of Medicine.

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