tci Part B Insider - 2003 Issue 5

DISEASE MANAGEMENT: Medicare Tries Disease Management

Can the Medicare program get smart about managing chronic disease? Seems we're about to find out. Health and Human Services Secretary Tommy Thompson Feb. 27 announced a three-year capitated demonstration program to promote care coordination strategies for Medicare beneficiaries with chronic diseases like stroke, congestive heart disease and diabetes. Participating organizations would receive a single capitated payment based on projected costs for each enrollee, using disease-specific risk adjusters being developed in connection with the Medicare+Choice program. Organizations would provide the full range of covered hospital and physician services for enrollees, mostly Medicare fee-for-service beneficiaries, including those eligible for both...

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