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The Centers for Medicare and Medicaid Services (CMS) unveiled a series of pilot programs in late August aimed at helping patients with diabetes or congestive heart failure reduce their health risks and preserve their quality of life.
Eight Medicare Health Support pilot programs will be rolled out in different parts of the U.S. this year, according to senior CMS adviser Sandy Foote. The voluntary programs, slated to run for 3 years, will include 160,000 preselected fee-for-service beneficiaries with diabetes, congestive heart failure, or both.
The programs will work directly with patients—at no charge—to help them understand and comply with their care plan, coordinate care with a variety of providers, and facilitate communication between patients and their health care team. Patients will receive reminders about appointments, access to nurse coaches, home monitoring if needed, and home visits and intensive case management when indicated.
Each program is "modeled different ways so we can see what works," Foote says. "This is big and groundbreaking."
CMS has rallied support for the initiative with 35 national partners, including AARP and the American Diabetes Association (ADA). Beneficiaries will receive a letter from ADA encouraging participation and compliance with the program, according to Foote. Collaboration with participants' providers is intended to enhance communication of relevant clinical information.
The effort was mandated by the Medicare Modernization Act of 2003 to
address burgeoning costs associated with chronic illnesses, which are
responsible for a disproportionate amount of Medicare costs. About 18% of
Medicare beneficiaries have diabetes, yet they account for 32% of Medicare
spending, according to CMS. 
Coming Soon to a Health Plan Near You
The first phase of the voluntary Medicare Health Support initiative will test a range of program models with various health care organizations (chosen through a competitive selection process). The programs will be paid based on achieving measurable improvements in clinical and financial outcomes and beneficiary satisfaction. Program launches for the first eight regions are:
Source: CMS
Footnotes
More information about the Medicare Health Support initiative is available at www.cms.hhs.gov/medicarereform/ccip.
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| DOC News | Diabetes | Diabetes Care | Clinical Diabetes | Diabetes Spectrum |
