Performance Improvement 2009. Have the Fifteen Medicare Coordinated Care Demonstration Programs Improved Health Outcomes and Reduced Costs for Beneficiaries?


This study determined whether the 15 individual Medicare Coordinated Care Demonstration (MCCD) programs improved health outcomes and reduced Medicare costs for their targeted diagnostic groups of chronically-ill beneficiaries. The study entailed a randomized clinical trial design with each program having two arms: an intervention group and a ‘usual care’ control group.

Researchers found that five programs in the demonstration had some modest favorable effects on quality without significantly increasing Medicare expenditures. One program was cost neutral; another was probably cost neutral; two had low enrollment and have closed; the fifth had only small, insignificant Part A & B savings, insufficient to offset its high per-beneficiary fee to Medicare. The remaining ten programs significantly increased costs to Medicare, although one reduced hospitalizations by 17 percent. While it failed to attain budget neutrality due to its high fee structure, future fee reduction for the program could potentially provide savings to Medicare. The Centers for Medicare & Medicaid Services granted conditional extensions (until 2010) to the three programs that either are providing, or have potential to provide, savings to Medicare, however, one of these and its parent vendor closed all operations in 2008.

Report Title: Third Report to Congress on the Evaluation of the Medicare Coordinated Care Demonstration (MCCD) ; Report may be obtained from Federal Contact
Agency Sponsor: CMS-ORDI, Office of Research, Development, and Information
Federal Contact: Carol Magee, 410-786-6611
Performer: Mathematica Policy Research, Inc.
PIC ID: 8960

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