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Can Disease Management Control Costs? Building on Findings from the Medicare Coordinated Care Demonstration

Mathematica is conducting four interrelated studies that leverage the results of a large demonstration funded by the Centers for Medicare & Medicaid Services (CMS) to test the ability of care coordination and disease management programs to control the costs of chronic health conditions. These studies are investigating the following topics:

1. The effects of care coordination on costs over a longer follow-up period than was observed during the demonstration and for different types of beneficiaries
2. The types of coordinated care programs that successfully reduce costs and how they can be replicated
3. Whether intensifying contacts at the time of hospital discharge contributes to reducing costs
4. Whether care coordination interventions are more effective at reducing costs for individuals whose doctors have many patients receiving the intervention than individuals whose doctors have fewer patients receiving the intervention

The project builds on findings from the evaluation of the Medicare Coordinated Care Demonstration (MCCD), the first large-scale randomized demonstration that tested care coordination. That demonstration enrolled 25,000 beneficiaries in 15 different care coordination programs. The beneficiaries suffered from chronic diseases, including congestive heart failure, diabetes, coronary artery disease, and chronic obstructive pulmonary disease. The four studies are using Medicare claims, site visits, telephone calls with programs, as well as patient survey data already collected. Findings are being disseminated to key stakeholders, including purchasers (private health plans, CMS, state Medicaid directors, and large employers), providers (vendors, physicians, and disease managers), and others, including congressional staffers, foundation personnel, and academics.