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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:
Cut Co-Pays for Prescription Drugs to Zero? Are You Crazy? No, and Here’s Why.
The tagline to a recent article in the Wall Street Journal [subscription required] reads: Employers, Insurers Bet That Covering More of the Cost of Drugs Can Save Money Over the Long Term for Chronic Conditions
Desperate for ways to curb soaring health-care costs, a groundswell of employers and health insurers are turning to a radically different approach: motivate patients to take not just the cheapest medicines, but the ones they need the most….
Behind the about-face is mounting evidence that higher copayments may […]
More Evidence Suggesting that Consumer Driven Health Plans Can Have a Negative Impact on Chronic Care
What impact will CDHPs (consumer driven health plans) have on patients with chronic conditions? Jason Shafrin of Healthcare Economist blog refers to a recent study examining this important issue:
The authors also found that increased cost sharing led to a slight increase in hospitalizations. However, when the subpopulation of individuals with chronic health conditions is examined, large increases in hospitalization rates are found. This means that individuals with chronic health conditions forego office visits and drug purchases due to the increase in price, […]
Despite Limited Penetration, Integrated Delivery Systems Have Advanced Chronic Care
The 1990’s experiment around development of integrated delivery systems (IDSs) mostly did not take root. This experiment was primarily about financial integration — doctors joining with hospitals so that they could together contract with health insurers for capitated reimbursement, hospitals starting their own health plan, or hospitals buying physician practices as a way of guaranteeing a future base of patients and revenues.
The systems and processes needed jointly to manage financial and clinical risk were an afterthought; information technology was not […]
Medicare and DM: Synthesis in 500 Words
Can I interest you in a 2 minute summary of DM in Medicare? Please read my posting Medicare Chronic Disease Management Direction? It’s Anybody’s Guess on the World Health Care Blog.
The World Health Care Blog is a unique experiment sponsored by the World Health Care Congress. Please also check out the excellent health care blogs of my fellow bloggers:
Tony Chen at Hospital Impact
Emily Devoto at The Antidote: Counterspin for Health Care and Health News
Matthew Holt at The Health Care Blog
Derek Lowe at In the […]
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 […]
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