Topic Overview

Many hospitals and insurers have developed disease management (DM) programs to educate people who have heart failure about their disease. Disease management includes a broad range of health services, such as home health care, visiting nurses, and rehabilitation. The goal of DM programs is to offer a combination of treatment, complication prevention, and education in a variety of settings.

Although it is a relatively new concept, studies and reports suggest that DM programs offer two main benefits:

• People receive more customized treatment.
• DM programs may reduce the overall cost of heart failure care by reducing the need for hospital stays.

How do DM programs work?

A range of providers and health plans focus on the following three aspects of heart failure treatment.

• Patient education: Teaching people about heart failure and how they can prevent progression of their condition
• Proper monitoring: Educating people on how to notice a flare-up of symptoms or a change in their symptoms of heart failure
• Decision support: Helping people decide when they should make a doctor appointment versus when to visit an urgent care center

To achieve these goals, heart failure disease management programs usually provide a wide variety of services. These services can include dietary consultations, health assessments, medicine information, weight-loss help, sodium/fluid management, and exercise programs and facilities. One of the main benefits of disease management is that it can be delivered by case managers and program coordinators right in your own home.

The main reason for DM programs

DM programs aim to decrease the chance of sudden flare-ups of symptoms. The most expensive part of heart failure treatment is the treatment of sudden (acute) flare-ups of symptoms. If an acute flare-up happens, you will often be hospitalized, your drug regimen will usually be changed, and the number of times that you see a doctor will increase. You can help prevent sudden flare-ups by following your self-care plan and taking your medicines correctly.

Are there DM programs everywhere?

DM programs are available in some hospitals and through large health insurers. But they are not available at every hospital or through every health plan. If you are interested in taking part in an organized DM program, ask your doctor or nurses about any programs for which you might be eligible.