A CMS disease-management pilot project failed to reduce hospitalizations, mortality rates and costs among heart disease and diabetes patients, according to a second report on the program issued by the CMS.
The report found a number of flaws in the pilot, called the Medicare Health Support Programs, which was mandated by the Medicare Reform Act of 2003. Eight pilots involving more than 160,000 fee-for-service Medicare beneficiaries nationwide launched in 2005 and 2006.
Among the shortcomings cited in the 88-page report to Congress were that the sickest and most vulnerable (and most costly) Medicare beneficiaries were less likely to agree to participate. In addition, the level of intervention to improve peoples disease conditions was inadequate, and fees exceeded any cost savings produced.
DMAA: The Care Continuum Alliance, a consortium of disease-management groups and advocates, said in a written statement that it regrets that the new analysis of the program diverges so significantly from that positive experience of other programs, including numerous examples in the private sector and innovative state Medicaid initiatives. The group said it welcomes further study on the selection of study populations and the severity and progression of their illnesses. -- by Rebecca Vesely