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Medicare DM

MGH Medicare Disease/Care Management Demo Shows Home Run Results!

Medicare has (finally) recently released a report showing home run results for a disease/care management demonstration project!

Evaluation of Medicare Care Management for High Cost Beneficiaries (CMHCB) Demonstration: Massachusetts General Hospital and Massachusetts General Physicians Organization (MGH)

Remind Me Again About the CMHCB Medicare Demo…

The CMHCB started in 2005. My recollection is that the demo requirements were extremely similar to the Medicare Health Support (MHS) project, with a few exceptions: 1) Applicants had to include direct care providers (delivery systems, physicians) in their program design, 2) patient populations […]

POE Award: Linda Magno of CMS Acknowledges the Elephant in the Room with Medicare DM

Just about everybody in the world has been talking about problems that Medicare is having with chronic disease management (DM) demonstration projects…everybody except the folks at Medicare.

Well, that’s finally changing. Today’s POE (plain old English) award is presented to Linda Magno, Director, Medicare Demonstrations at CMS (Centers for Medicare and Medicaid Services).

Here are a couple of slides from Ms. Magno’s presentation at the Patient Centered Primary Care Collaborative Summit on November 7:

Disease Management and the Medicare Health Support (MHS) Project: “Houston, we have a problem.”

Thomas Wilson, PhD, DrPH and Vince Kuraitis, JD, MBA

The conventional wisdom in the disease management (DM) community has been that the Medicare Health Support (MHS) project would provide the evidence to resolve two issues:

First, MHS would once-and-for-all resolve the issue of “does DM have ROI? (return on investment).” It was thought that the randomized control trial process employed in MHS would provide scientific evidence to prove that DM has a positive ROI, clearing the way for unqualified acceptance and widespread […]

First “Official” Report on Medicare Health Support DM Pilot Finds Virtually No Evidence of Success

I know that I’m sounding like a broken record.

The first “official” results from the Medicare Health Support (MHS) disease management (DM) pilot projects were published last week.  While the results are preliminary, there is virtually no evidence of any early success.  Here are three key findings from the executive summary of the report:

Mathematica Researchers Summarize Disappointing Results Across 4 Medicare DM Demonstrations

Presenting at the Annual Academy Health Research Meeting earlier this week, representatives from  Mathematica Research and CMS (Centers for Medicare and Medicare Services) presented findings across several Medicare disease management (DM) demonstration/pilot programs. 

Again, the findings show minimal evidence of success in any of the Medicare DM programs. Several of the slides from Randall Brown of Mathematica cut to the chase:

A Founding Father of DM Astonishingly Declares: “My Kid is Ugly”

Al Lewis, one of the founding fathers of DM, has shaped the face of the DM industry probably more than other any single individual. (This is all fine unless you happen to be the person whose face is being shaped by Al.)

Al has been unabashedly pro-DM.  Until now.  Al writes in a recent article in Managed Healthcare Executive:

Disease management as we now define it may be on its last legs, though no one knows it yet. The Disease Management Purchasing Consortium has noticed that the savings in all […]

Yet Another Dark Cloud in the Stormy Skies of Medicare DM

Medicare’s major thrust at chronic disease management innovation — the Medicare Health Support (MHS) pilot project — continues to gather storm clouds.

Today’s POO (persistent obfuscatory orations) Award goes to Healthways for their explanation of  MHS progress (or lack thereof) in an April 4 press release.  If you can understand what they’re saying about MHS (see p. 3) without having your CPA explain it, you’re a lot smarter than I am:

The recently received sixth quarterly CMS report for the MHS pilots continued to cumulatively […]

One More Dark Cloud in the Stormy Skies of Medicare DM

Mathematica Research has just released a report: The Evaluation of the Medicare Coordinated Care Demonstration: Findings for the First Two Years.  It’s not pretty.

Section F of the Executive Summary is entitled “Synthesizing the Findings: What Works, and What Doesn’t”.  That section begins:

Given that few of the programs have shown convincing evidence to date of reducing beneficiaries’ need for hospitalizations and saving money or of improving the quality of care received, there is relatively little assessment that can be done yet […]