The Centers for Medicare & Medicaid Services has granted three-year extensions for three successful participants in the Care Management for High Cost Beneficiaries Demonstration.
"We have been striving for years to find ways to improve the quality of care for Medicare patients through greater coordination in a way that would also save money for Medicare," said CMS Acting Administrator Kerry Weems.
Care management for high cost beneficiaries is a provider-based service to improve quality of care and reduce costs for fee-for-service beneficiaries who have one or more chronic diseases. The services support collaboration among participants' primary and specialist providers to enhance communication of relevant clinical information. They are intended to help increase adherence to evidence-based care, reduce unnecessary hospital stays and emergency room visits and help participants avoid costly and debilitating complications.
The extensions were awarded to Key to Better Health, a division of Village Health; the Massachusetts General Care Management Program; and the Health Hero Network's Health Buddy Project.
"The success of these three partners shows us that better coordination and the introduction of information technology can improve Medicare beneficiaries' understanding of their condition and their ability to follow medical advice," Weems said.
The programs identified are unique because of their defined intervention focus on the fee-for-service Medicare population. They're noted as having a positive impact on selected high-cost Medicare beneficiaries and meeting and/or exceeding the savings target required in the demonstration agreement.
The CMHCB demonstration was approved to provide disease management services for thousands of beneficiaries by awarding six organizations with populations in sizes from 1,800 to 15,000.
By extending the demonstration for another three years and frequently evaluating their financial status, CMS says each of the programs will have the opportunity to continue to impact their populations, maximize savings and determine if they're replicable elsewhere.
"These programs are showing us yet another way to develop programs that will improve communication between healthcare providers and their patients, eliminate duplicative and unnecessary care and improve overall quality," said Weems.