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Disease Management For Chronically Ill Beneficiaries In Traditional Medicare /

개인저자
Bott, David M. et al
수록페이지
86-98 p.
발행일자
2009.01.22
출판사
Project Hope
초록
[영문]We summarize the Centers for Medicare and Medicaid Services’ (CMS’s) experience with disease management (DM) in fee-for-service Medicare. Since 1999, the CMS has conducted seven DM demonstrations involving some 300,000 beneficiaries in thirty-five programs. Programs include provider-based, third-party, and hybrid models. Reducing costs sufficient to cover program fees has proved particularly challenging. Final evaluations on twenty programs found three with evidence of quality improvement at or near budget-neutrality, net of fees. Interim monitoring covering at least twenty-one months on the remaining fifteen programs suggests that four are close to covering their fees. Characteristics of the traditional Medicare program present a challenge to these DM models