Pilot program seeks to help patients with chronic conditions
Case Management Weekly, February 22, 2006
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CMS recently announced it has enrolled 100,000 Medicare beneficiaries in a pilot program to test a coordinated care system for individuals with multiple chronic conditions.
According to CMS, individuals with five or more chronic conditions make up 23% of Medicare beneficiaries, but account for 68% of costs.
Such patients are often under the care of multiple specialists who don't communicate, share medical records, or coordinate treatment plans, increasing the risk that they will be hospitalized when different doctors recommend conflicting treatments.
Under the pilot program, CMS will pay eight companies monthly fees to coordinate the beneficiaries' care. Most of the companies will use nurses working from call centers, and some will make house calls to check on patients. The program will test whether this new layer of care can actually reduce cost in the long run.
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