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Disease management: findings from leading state programs.

Ben Wheatley

    State Coverage Initiatives Issue Brief : a National Initiative of the Robert Wood Johnson Foundation
    |January 1, 2003
    PubMed
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    Disease management programs aim to lower healthcare costs by enhancing the health of chronically ill individuals. Over 20 states are implementing these Medicaid programs for various populations.

    Area of Science:

    • Health Services Research
    • Public Health Policy

    Background:

    • Chronic illness management presents significant healthcare cost challenges.
    • Disease management programs (DMPs) are increasingly adopted to mitigate these costs.
    • Medicaid programs are central to managing the health of vulnerable, chronically ill populations.

    Purpose of the Study:

    • To examine the current landscape of Medicaid disease management program implementation.
    • To understand the strategies states are employing to contain costs through DMPs.

    Main Methods:

    • Analysis of state-level initiatives in Medicaid program development.
    • Review of program structures for primary care case management and fee-for-service populations.

    Main Results:

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    • More than 20 states are actively developing or implementing DMPs.
    • Programs target both primary care case management and fee-for-service Medicaid beneficiaries.
    • Focus on cost containment through improved health outcomes for the chronically ill.

    Conclusions:

    • Medicaid disease management programs are a growing strategy for states to manage chronic illness costs.
    • Implementation varies across states, targeting diverse Medicaid populations.
    • The trend indicates a significant policy shift towards proactive chronic care management within Medicaid.