Chronic care improvement in Medicare FFS: cosmetic or transforming?

As part of the Medicare Modernization Act of 2003, Congress mandated development of "Voluntary Chronic Care Improvement Programs under Traditional Fee-For-Service." These programs represent an ambitious new federal attempt to reduce quality failings under the Medicare fee-for-service (FFS) plan cost-effectively and on a large scale. CCI programs cannot be expected to rescue Medicare from current cost pressures or from the perverse incentives inherent in FFS provider reimbursement, but they may reduce health risks, yield savings, and foster progress toward system integration on behalf of some major subgroups of chronically ill beneficiaries who need added support to manage their health effectively.