Case management for high-cost Medicare beneficiaries.
We estimated the effects of three Health Care Financing Administration (HCFA)-funded case management demonstrations for high-cost Medicare beneficiaries in the fee-for-service (FFS) sector. Participating beneficiaries were randomly assigned to receive case management plus regular Medicare benefits or regular benefits only. None of the demonstrations improved self-care or health or reduced Medicare spending. Despite the lack of effects of these interventions, case management might be cost-effective if it includes greater involvement of physicians, is more well-defined and goal-oriented, and incorporates financial incentives to generate savings in Medicare costs. Models incorporating these changes should be investigated before abandoning Medicare case management interventions.
Schore
J L
JL
Mathematica Policy Research, Inc., USA. jschore@mathematica-mpr.com
Brown
R S
RS
Cheh
V A
VA
D019090:Case Management / Q000191:economics / Q000458:organization & administration*; D014487:Centers for Medicare and Medicaid Services, U.S.; D003625:Data Collection; D018588:Fee-for-Service Plans / Q000191:economics*; D017048:Health Care Costs; D006302:Health Services Research; D006801:Humans; D006278:Medicare / Q000191:economics / Q000458:organization & administration*; D017146:Models, Organizational; D010865:Pilot Projects; D012648:Self Care; D014481:United States