Performance Improvement 2008. Do Early Implementation Costs and Quality Meet Expectations in the Medicare Health Support Program?

01/01/2008

This study reviewed the scope of the Voluntary Chronic Care Improvement Programs under Traditional Fee-for-service Medicare, their design and early implementation experience, as well as preliminary cost and quality findings through the first six months of operation.

These programs have been implemented under the name Medicare Health Support. Eight organizations initiated care management programs in different regions, 2005-2006. In each region, approximately 30,000 Medicare beneficiaries with heart failure or diabetes were identified as eligible; 20,000 were offered the intervention and 10,000 served as a comparison population. The population selected was frail, with multiple co-morbidities and high utilization of health care services. The organizations varied in how they engaged beneficiaries and met their needs. Participation rates in the first six month period ranged from 65 percent to 92 percent. Participating beneficiaries tended to be a healthier subset of the intervention group.

Within the first six months of operations the programs made only modest progress toward achieving targets for savings to the Medicare program, far less than their management fees. It was too early to assess the programs´ impact on clinical quality or beneficiary satisfaction. A report containing additional findings will be available in 2008.

Report Title: Evaluation of Phase I of Medicare Health Support (Formerly Voluntary Chronic Care Improvement) Pilot Program Under Traditional Fee-for-Service Medicare: Report to Congress, http://www.cms.hhs.gov/Reports/Downloads/McCall.pdf
Agency Sponsor:
CMS-ORDI, Office of Research, Development, and Information
Federal Contact: Mary Kapp, 410-786-0360
Performer: RTI International
PIC ID: 8662

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