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Evaluation of Medicare Health Support chronic disease pilot program.

Cromwell J, McCall N, Burton J - Health Care Financ Rev (2008)

Bottom Line: Eight disease management (DM) companies have contracted with CMS to improve clinical quality, increase beneficiary and provider satisfaction, and achieve targeted savings for chronically ill Medicare FFS beneficiaries.In this article, we present 6-month intervention results on beneficiary selection and participation rates, mortality rates, trends in hospitalizations, and success in achieving Medicare cost savings.Results to date indicate limited success in achieving Medicare cost savings or reducing acute care utilization.

View Article: PubMed Central - PubMed

Affiliation: Research Triangle Institute International, Waltham, MA 02451, USA. jcromwell@rti.org

ABSTRACT
The Medicare Program is conducting a randomized trial of care management services among fee-for-service (FFS) beneficiaries called the Medicare Health Support (MHS) pilot program. Eight disease management (DM) companies have contracted with CMS to improve clinical quality, increase beneficiary and provider satisfaction, and achieve targeted savings for chronically ill Medicare FFS beneficiaries. In this article, we present 6-month intervention results on beneficiary selection and participation rates, mortality rates, trends in hospitalizations, and success in achieving Medicare cost savings. Results to date indicate limited success in achieving Medicare cost savings or reducing acute care utilization.

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Related in: MedlinePlus

Difference in Changes in Medicare PBPM Between Intervention and Comparison Groups From Base Year Through First 6 Pilot Months, by MHSO
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Related In: Results  -  Collection


getmorefigures.php?uid=PMC4195046&req=5

f1-hcfr-30-01-047: Difference in Changes in Medicare PBPM Between Intervention and Comparison Groups From Base Year Through First 6 Pilot Months, by MHSO

Mentions: In Figure 1, we present a difference-in-differences analysis of trends in PBPMs for each of the eight MHSOs starting from each beneficiary's own base year PBPM. MHSO 1's intervention group PBPM increased by $208 between the baseline year and the first 6-month period. Over the same period, MHSO 1's comparison group PBPM increased $231, implying $23 in PBPM Medicare gross savings. Six of the eight MHSOs exhibited lower relative rates of growth in Medicare PBPM payments between the year prior and first 6 months of the pilot program. Yet, only the savings for MHSO 3 and 6 were statistically significant from zero (p<0.05). To achieve statistical significance, the differences-in-trends needed to be between $62-$90, or 4.4-5.8 percent of the comparison group's PBPM. MHSO 7's intervention PBPM paralleled its comparison group, while MHSO 8's intervention PBPM grew faster than its comparison group's PBPM.


Evaluation of Medicare Health Support chronic disease pilot program.

Cromwell J, McCall N, Burton J - Health Care Financ Rev (2008)

Difference in Changes in Medicare PBPM Between Intervention and Comparison Groups From Base Year Through First 6 Pilot Months, by MHSO
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4195046&req=5

f1-hcfr-30-01-047: Difference in Changes in Medicare PBPM Between Intervention and Comparison Groups From Base Year Through First 6 Pilot Months, by MHSO
Mentions: In Figure 1, we present a difference-in-differences analysis of trends in PBPMs for each of the eight MHSOs starting from each beneficiary's own base year PBPM. MHSO 1's intervention group PBPM increased by $208 between the baseline year and the first 6-month period. Over the same period, MHSO 1's comparison group PBPM increased $231, implying $23 in PBPM Medicare gross savings. Six of the eight MHSOs exhibited lower relative rates of growth in Medicare PBPM payments between the year prior and first 6 months of the pilot program. Yet, only the savings for MHSO 3 and 6 were statistically significant from zero (p<0.05). To achieve statistical significance, the differences-in-trends needed to be between $62-$90, or 4.4-5.8 percent of the comparison group's PBPM. MHSO 7's intervention PBPM paralleled its comparison group, while MHSO 8's intervention PBPM grew faster than its comparison group's PBPM.

Bottom Line: Eight disease management (DM) companies have contracted with CMS to improve clinical quality, increase beneficiary and provider satisfaction, and achieve targeted savings for chronically ill Medicare FFS beneficiaries.In this article, we present 6-month intervention results on beneficiary selection and participation rates, mortality rates, trends in hospitalizations, and success in achieving Medicare cost savings.Results to date indicate limited success in achieving Medicare cost savings or reducing acute care utilization.

View Article: PubMed Central - PubMed

Affiliation: Research Triangle Institute International, Waltham, MA 02451, USA. jcromwell@rti.org

ABSTRACT
The Medicare Program is conducting a randomized trial of care management services among fee-for-service (FFS) beneficiaries called the Medicare Health Support (MHS) pilot program. Eight disease management (DM) companies have contracted with CMS to improve clinical quality, increase beneficiary and provider satisfaction, and achieve targeted savings for chronically ill Medicare FFS beneficiaries. In this article, we present 6-month intervention results on beneficiary selection and participation rates, mortality rates, trends in hospitalizations, and success in achieving Medicare cost savings. Results to date indicate limited success in achieving Medicare cost savings or reducing acute care utilization.

Show MeSH
Related in: MedlinePlus