The demise of Medicare Health Support

I guess we knew it, but here’s the confirmation in the analysis of the first 18 months from CMS.

The summary: DM companies in Medicare Health Support enrolled healthier than average populations; they had limited to no impact on improving their patients’ care, satisfaction or outcomes; and didn’t save any money.

I wonder how Disease Management is going to fare in the future. It’s clear that this "occasional remote intervention" model needs to change.

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NateVince KuraitisMaggie MaharDeron S. Recent comment authors
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Sever personal liability including loss of coverage and death. You only have to watch a couple non compliant diabetics lose their feet then legs then die before you realize taking care of one’s health is a personal issue and regardless of your efforts some people will refuse to participate. The question then is how much should society spend treating these people who don’t care themselves? It’s a decision no politician will ever make and one the more Altruistic will deny even needs discussion but it is a real issue. I have cients that have begged employees to get help and… Read more »

Vince Kuraitis

Maggie, you point out an unfortunate irony in the MHS project. When the RFP was released, it read “come one, come all” and encouraged any interested parties to submit proposals. Over 500 people attended the initial bidders conference in person and another 200 listened on the phone. The interested group represented virtually every sector of health care. The “guaranteed-savings model” of MHS is familiar only to DM companies and health plans. In essence, contractors are at risk at forfeiting up to 100% of their fees if they did not hit satisfaction, outcome, AND financial targets. Once they understood the risks… Read more »

Maggie Mahar

I would note that this pilot was attempting to improve outcomes and save money within a fee-for-service model.
I wonder if the results would have been different if
large multi-speciality medical centers where doctors work on salalry (and collaborate with each other) had
run the programs. . ..

Deron S.

Clearly both the model and the beneficiaries need to change. Sadly, success will only come with more intense intervention because people just don’t seem to want to be bothered with maintaining their health these days. I’m being a little harsh there, but’s it’s a reality that is playing out more and more every year. As someone that reads Health Affairs, I’m sure you read the Sept/Oct issue that had a few articles challenging the current physician practice business model. I thought it was great reading and I agree that other models must develop to fit specific conditions. DM companies are… Read more »