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Summary
Coordinated care, a blend of case and disease management, aims to improve health for chronically ill patients and reduce costs. This Centers for Medicare & Medicaid Services project shows potential beyond traditional managed care models.
Area of Science:
- Healthcare Management
- Health Services Research
- Chronic Disease Management
Background:
- Health Maintenance Organizations (HMOs) are withdrawing from Medicare managed care programs.
- The Centers for Medicare & Medicaid Services (CMS) is exploring alternative models to improve care and reduce costs.
Purpose of the Study:
- To evaluate the effectiveness of a coordinated care model for chronically ill patients.
- To demonstrate potential cost savings and health improvements compared to existing managed care approaches.
Main Methods:
- Implementation of a demonstration project focused on coordinated care.
- Integration of case management and disease management strategies.
- Empowering patients with resources for active self-care management.
Main Results:
- The coordinated care model shows promise in enhancing patient health outcomes.
- Potential for significant reduction in overall healthcare expenditures.
- Positive patient engagement in managing their own health conditions.
Conclusions:
- Coordinated care offers a viable alternative to traditional managed care for vulnerable populations.
- This model can improve patient well-being and achieve greater cost-efficiency.
- Further exploration of coordinated care is warranted within Medicare programs.