How Changes in Washington University's Medicare Coordinated Care Demonstration Pilot Ultimately Achieved Savings

This article analyzed the experiences of the School of Medicine’s care-management program as it took part in the Medicare Coordinated Care Demonstration, with the goal of reducing hospitalizations and Medicare spending or improving quality while remaining cost neutral. The study showed that changes made to the intervention transformed a program that had increased total costs 12 percent to one that achieved cost neutrality for all chronically ill enrollees. These changes included comprehensive medication management and transitional care, more in-person contact by care coordinators with both patients and providers (while still mainly using phone contact), and more systematic patient assessments to identify unmet needs or barriers to following care plans. Savings were driven by 55 percent of enrollees who were high risk; implementing these changes saved Medicare 10 percent for these patients. The study demonstrates the importance of delivering the right services to the right people.