The effect of accurate patient screening on the cost-effectiveness of case management programs

Gerontologist. 1997 Dec;37(6):777-84. doi: 10.1093/geront/37.6.777.

Abstract

Case management programs are expensive and therefore require careful screening of enrollees to ensure cost-effectiveness. Screening tools, however, are imperfect, with positive predictive values usually below 50%. This article examines the relationship between the accuracy of the screening tools and the cost-effectiveness of case management. Using data from a Medicare health maintenance organization (HMO), we develop an optimized 5-question screening tool. We then simulate the use of this screening tool and its impact on the cost-effectiveness of several hypothetical case management programs. The article demonstrates that even screening tools with only 20-30% positive predictive value could turn a case management program into a cost-effective program.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Aged
  • Cost-Benefit Analysis
  • Costs and Cost Analysis
  • Female
  • Health Maintenance Organizations / economics
  • Humans
  • Linear Models
  • Male
  • Managed Care Programs / economics*
  • Medicare
  • Patient Selection*
  • Predictive Value of Tests
  • Risk Factors
  • Surveys and Questionnaires
  • United States