Care Coordination Programs Don't Benefit Medicare Patients

Few such programs reduce hospitalizations, monthly expenditures or improve quality of care
By Rick Ansorge
HealthDay Reporter

TUESDAY, Feb. 10 (HealthDay News) -- For Medicare beneficiaries with chronic illnesses, most care coordination programs have little impact on reducing hospitalizations and costs or improving quality of care, according to a report published in the Feb. 11 issue of the Journal of the American Medical Association.

Deborah Peikes, Ph.D., of Mathematica Policy Research Inc., in Princeton, N.J., and colleagues studied 18,309 eligible fee-for-service Medicare patients -- most of whom had congestive heart failure, coronary artery disease or diabetes -- who were randomly assigned to one of 15 care coordination programs or usual care.

In 13 of the 15 programs, the investigators found that hospitalizations were not significantly different between the intervention and usual care groups. One program was associated with a 17 percent lower rate of hospitalizations and another program was associated with a 19 percent higher rate of hospitalizations. In three programs, the researchers found that monthly Medicare expenditures were 9 to 14 percent lower for the intervention group than the usual care group, but that the savings offset fees in only two programs. The authors note that the favorable findings for these two programs suggest that care coordination programs have the potential to be cost-neutral and improve patients' well-being.

"The modest benefits suggest that future research will need to determine how to more effectively improve patient outcomes," the authors conclude. "The successful interventions also may offer more detailed lessons for medical homes about how best to educate and monitor patients, the types of patients for whom they are likely to be most effective, and how to help patients overcome barriers to better self-care."

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