Coordinating Care for Medicare Beneficiaries: Early Experiences of 15 Demonstration Programs, Their Patients, and Providers, Appendix A.

Chronic illnesses such as arthritis, heart disease, and diabetes afflict many individuals and create major costs for Medicare. Most Medicare HMOs have developed programs or contracted with disease management or case management providers for programs designed to improve care for people with chronic illnesses. This report provides an early look at 15 demonstration programs designed to test whether these approaches can achieve similar results in Medicare fee-for-service. Although it is too early in the study to estimate effects on service use or costs, the authors note that clients and physicians have been responding favorably to the programs. Compared with a control group, program clients report better access to information and appointments, better communication among providers, and greater understanding of their conditions. A majority of physicians for participating clients thought that the program improved patient care, helping them identify previously unknown client problems and influencing their clinical decisions in some cases.