Project Goal: “To test whether providing coordinated care services to Medicare fee-for-service beneficiaries with complex chronic conditions can yield better patient outcomes without increasing program costs. The selected projects represent a wide range of programs, use both case and disease management approaches, and operate in both urban and rural settings.”
Participants and Timeline: 15 sites nationwide, 2002-2014
Overall, the program did not reduce hospitalizations or expenses from 2002-2010.
Patients who met the criteria for “high-risk” were about 15% of the beneficiary population included in the study. High-risk patients had significantly lower hospitalizations (34%) compared to controls.
High-risk patients had significantly lower Medicare expenditures (22%) than controls.
Patients with coronary artery disease who had not been previously hospitalized had significantly lower 2-year mortality rates compared to controls.
After the initial evaluation in 2010, the program was extended through 2014 to focus exclusively on high-risk patients. The study authors, conducted by Mathematica Policy Research, concluded: “Despite the strongly favorable findings before the extension, interim evaluation results since the extension found that the program did not measurably reduce hospitalizations, mortality rates, or emergency department (ED) visits during the first 44 months of the extension.”
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