ABSTRACT
When one leaves the realm of the individual patient encounter, the question of the management of a series of encounters becomes an issue. The right choice can be made by a patient and a doctor for one event, but the disease process and the behavior that might have exacerbated it is drawn from patient lifestyle, the social situation, family heredity, social situations, etc. The focus of health benefit program construction has traditionally been to manage the event and not the process. Enter “disease-state management” and the process of defining the environment and the background behind the event for which the patient is seeking healthcare treatment.
