what is a carve-out, and what is its role in disease management?
Is it an interim step to a disease management programme? Is it a subset of a disease management programme? Does a carve-out have benefits as a stand alone programme? This article addresses these questions by looking at both heart and cancer carve-outs versus disease management. Through these 2 examples, the parameters for disease management and carve-outs are compared. Carve-outs treat the episodic events of a disease and are effective when the disease is independent of other patient conditions, when the disease has a defined beginning and end, and when treatment for the disease is predictable and definable. When a disease has many interdependencies or cause-effect relationships with other conditions, disease management offers the best method of providing treatment for the complete life-cycle of the disease. `Managed care’ began by managing access to goods and services, has matured to managing episodes of acute/costly care needs and is gradually migrating to managing the continuum of c
