thepumphandle...Last week, the Congressional Budget Office released some disappointing news: several demonstration projects aiming to contain growth in healthcare spending are not showing cost savings. Specifically, the Centers for Medicare and Medicaid Services have been focusing on programs involving either disease management and care coordination or value-based payment systems for the fee-for-service Medicare population. A CBO issue brief reviews programs in both these categories that have been conducted over the past two decades, and I'm particularly interested in what it says about the disease management/care coordination projects.
CBO reports on six major demonstration projects involving 34 disease-management programs that focused on the management of chronic conditions -- mainly diabetes, congestive heart failure, and coronary artery disease -- among Medicare beneficiaries. All of the programs relied on nurses functioning as case managers "to educate patients about their chronic illnesses, encourage them to follow self-care regimens, monitor their health, and track whether they received recommended tests and treatments."
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