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Medicare disease management

Executive Summary

Demonstration disease management project with Medicare fee-for-service beneficiaries gets under way in Oklahoma, with a program run by Lifemasters, and in Washington, D.C. and Maryland, with an American Healthways program. Both began Aug. 1. CMS announced Aug. 2 that the Medicare Health Support pilot programs will begin later in August in Western Pennsylvania (Health Dialog) and Mississippi (McKesson Health Solutions) and in the fall in Northwest Georgia (CIGNA), Chicago (Aetna), Central Florida (Humana) and Tennessee (XLHealth). Details are still being worked out for the Brooklyn/Queens, N.Y. demonstration site with the Visiting Nurse Service of New York and United HealthCare Services-Evercare. Mandated by the Medicare Modernization Act, the project focuses on providing a variety of disease management tools, such as nurse coaching and drug compliance reminders, for patients with diabetes or congestive heart failure. The demonstration is reviewed in depth in a new report, Disease Management, Medicare Modernization and the Keys to Success, produced by Datamonitor in association with F-D-C Reports (1fdcreports.com/diseasemanagement)...

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