Over the past decade, the concept of disease management has gained favor as a way to improve health care for people with chronic conditions. Now the Medicare program will formally evaluate a disease management approach to diabetes through a demonstration project to learn how such programs work and how to best make them available to Medicare beneficiaries.

Medicare administrators are interested in taking better care of people with chronic conditions, since studies have shown that a relatively small number of Medicare beneficiaries with chronic illnesses such as diabetes, coronary heart disease and congestive heart failure accounts for a disproportionate share of Medicare costs. These patients typically receive fragmented health care across many providers and sites of care, and they often require repeated, costly hospitalizations. This situation is both costly for Medicare and undesirable for patients, who may not receive the best treatment.

In a disease management approach, all of a patient's care is coordinated. The demonstration projects will also cover the cost of prescription drugs for those patients enrolled - a plus for these patients, whose medications are not generally covered under Medicare. The evaluation will also include disease management programs for those with advanced-stage congestive heart failure and coronary heart disease.

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Source:  Centers for Medicare & Medicaid Services. Medicare announces disease management demonstration for chronically ill. Press release, Feb. 21, 2002.