15-site randomized trial of coordinated care in Medicare FFS.
Medicare beneficiaries in fee-for-service (FFS) who had chronic illnesses and volunteered to participate in 15 care coordination programs were randomized to treatment or control status. Nurses provided patient education (mostly by telephone) to improve adherence and ability to communicate with physicians. Patients were contacted an average of two times per month. The findings after 2 years are not encouraging. Few programs improved patient behaviors, health, or quality of care. The treatment group had significantly fewer hospitalizations in only one program; no program reduced gross or net expenditures. However, effects may be observed when 4 years of followup are available and sample sizes increase.
Brown
Randall
R
Mathematica Policy Research, Inc., Princeton, NJ 98540, USA. rbrown@mathematica-mpr.com
Peikes
Deborah
D
Chen
Arnold
A
Schore
Jennifer
J
D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000628:therapy*; D018588:Fee-for-Service Plans; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D006278:Medicare; D008875:Middle Aged; D010865:Pilot Projects; D011787:Quality of Health Care; D040242:Risk Reduction Behavior; D014481:United States