Impacts of a Disease Management Program for Dually Eligible Beneficiaries

Abstract

This articles examines interim impacts of a disease management demonstration for Medicare fee-for-service beneficiaries also enrolled in Medicaid (dual eligibles). The study randomly assigned dual eligibles with congestive heart failure, coronary artery disease, and/or diabetes to treatment or control groups for a population-based program that provides telephone patient education and monitoring services. Findings during the first 18 months show virtually no overall impacts on hospital or emergency room use, Medicare expenditures, quality of care, or prescription drug use for the 33,000 enrollees. However, for beneficiaries with congestive heart failure who resided in high-cost counties, the program reduced Medicare expenditures by 9.6 percent.