Medical Management Guide, 2009, Version 3.0 - Tricare

Medical Management GuideVersion 3.0Disease ManagementPage 105Disease ManagementSECTIONIVINTRODUCTIONDisease Management (DM) is focused onoptimizing health in specific populations.It should be noted that all componentsof MM — Utilization Management (UM), CaseManagement (CM), and Disease Management(DM) — blend together when they areoperationalized. The lines of distinction betweenUM, CM, and DM programs may become lessdefined as UM, CM, and DM personnel collaboratewith Military Treatment Facility (MTF) providers andstaff to achieve the best healthcare benefit possiblefor the patient and the organization.Fig. 27 highlights the role of DM over the variousstages of health care (see also Section I, MedicalManagement Essentials). Specifically, as the focusof healthcare delivery moves along the PopulationHealth continuum, when the focus of health care isprimary prevention, interventions are most effectivefor groups of people with similar characteristics. Thesame is true when providing healthcare services atthe level of secondary prevention for people whoFig. 27 – Disease Management within the Integrated Medical Management Model*See also Section I, Medical Management Essentials: Fig. 4, Integrated Medical Management Model (IM3) with Key info, page 14.