Next Things First

More Perspective on Cutting Medicare Health Support (yes, this came out last month…) by Rob Coppedge
September 18, 2008, 7:48 pm
Filed under: chronic care, medicaid/medicare | Tags: ,
Before we launched the blog, Jonathan Burkland, an investment banker at Stanford Group who has followed the Medicare Health Support issue closely and knows a bit about the disease management industry, had an opinion piece in Modern Healthcare on the subject.

Chronic-disease patients unquestionably are a heavy drain on the healthcare system. The Centers for Disease Control and Prevention estimates that chronic-disease patients account for 75% of America’s healthcare bill.

The CMS seems to have ignored those facts, and earlier this year said it intends to terminate the project with the last of the pilots shutting down in December…

…how can the CMS presumably believe that the interim results of phase one did not justify continued exploration into phase two? Are there other elements that could have contributed? Did patient enrollment, for example, take longer than planned? Did the program run long enough for the initial investment in areas such as patient recruitment and compliance to be offset by the long-term reduction in expensive care, such as emergency room visits?

We agree that Congress and CMS has “cut the cord” on this program too quickly. Plagued by bad data feeds and should-have-been-expected difficulties in identifying, reaching out to and managing the health of Medicare members in ways that hadn’t been attempted before, these efforts deserve a second-life. As Burklund points out:
There is some good news on this front. The recently passed Medicare bill, which survived a presidential veto, calls for a study on the feasibility of establishing a Medicare Chronic Care Practice Research Network of providers who would test new models of care coordination and other care approaches for chronically ill beneficiaries, and expand those models to the larger Medicare patient population, if appropriate. Also, the bill calls for a thorough study of the methods of analysis and the program design of Medicare Health Support. Maybe this can get things back on track.