Documenting participation in an employer-sponsored disease management program: selection, exclusion, attrition, and active engagement as possible metrics.

OBJECTIVE The objective of this study was to document participation in a large employer-sponsored disease management program. METHODS This retrospective study tracked participation and attrition rates for asthma, diabetes, coronary heart disease, and congestive heart failure programs over a 4-year period. RESULTS Across all four illnesses, only 25% of those identified had any participation. Over 12 months, only 7% continued participating. Of the 93% who were lost, 35% were excluded, 15% could not be contacted, 25% declined to participate, and 17% dropped out over time. All groups improved their adherence to recommended treatment guidelines. Nonparticipants showed the greatest absolute improvement in receiving recommended medical services; however, they also had the lowest rate of service use at baseline and remained lowest at follow up. CONCLUSIONS Documenting active engagement and attrition rates may provide useful information for decision-makers.