Population-based disease management under fee-for-service Medicare.
Medicare policymakers are considering testing population-based disease management (PDM) programs under fee-for-service (FFS) Medicare as a way to improve health and cost outcomes for selected subgroups of chronically ill beneficiaries. This paper provides a brief overview of how PDM programs are evolving in the private sector and describes how they differ from other approaches already being tested in Medicare disease management demonstrations. It also discusses some key opportunities and issues to be considered in adapting PDM programs for testing in the FFS Medicare context.
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Sandra M
SM
Health Insurance Reform Project, George Washington University, Washington, DC, USA. smfoote@gwu.edu
D003362:Cost-Benefit Analysis; D019468:Disease Management; D004465:Economic Competition; D004608:Eligibility Determination; D018588:Fee-for-Service Plans / Q000191:economics / Q000458:organization & administration*; D006801:Humans; D007356:Insurance, Pharmaceutical Services; D006278:Medicare / Q000191:economics / Q000458:organization & administration*; D011159:Population Surveillance; D014481:United States