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Update on Medicare Chronic Care Improvement Programs Sandra M. Foote Division of Chronic Care Improvement Programs Center for Medicare Management January.

Published byMoris Cain Modified over 9 years ago

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Presentation on theme: "Update on Medicare Chronic Care Improvement Programs Sandra M. Foote Division of Chronic Care Improvement Programs Center for Medicare Management January."— Presentation transcript:

1 Update on Medicare Chronic Care Improvement Programs Sandra M. Foote Division of Chronic Care Improvement Programs Center for Medicare Management January 28, 2005

2 “Voluntary Chronic Care Improvement under Traditional Fee-For-Service”* *Section 721 of P.L. 107-183, Medicare Prescription Drug, Improvement and Modernization Act of 2003

3 Beneficiaries’ Physicians Targeted Beneficiaries CCI Organization DHHS Fees at risk: QI, $, satisfaction Agreement, $ Data exchange

4 Key Features of CCIP Voluntary participation No change of plans, providers, benefits, or claims administration No shift of insurance risk to CCI organizations Supportive, not restrictive Not a substitute for current care

5 PHASE I - DEVELOPMENTAL Large scale, regional pilot programs to be tested through 3-year randomized controlled trials 9 regional program awards made 12/08/04 20,000 chronically ill beneficiaries per program; 10,000 per control group Staggered start dates in 2005

6 Preliminary Findings Market response Physician involvement CMS infrastructure development

7 Market response Innovative proposals Broad spectrum of interventions Diverse programs Regions with high disease prevalence and low quality rankings

8 1.Humana 2. Aetna 3. Lifemasters 4. McKesson 5. CIGNA 6. VNSNY/UHCS 7. Health Dialog 8. XLHealth 9. American Healthways 1 2 3 45 67 8 9 Medicare Chronic Care Improvement Programs Diabetes Prevalence Medicare non-HMO

9 Physician Involvement Many new national and regional alliances developing with CCIP awardees Examples: - American College of Physicians - American College of Cardiology - American Academy of Family Physicians

10 CMS Investment Strong leadership support Staff and contractors on board Development work underway -Performance monitoring system -Information management system -CMS outreach -Planning for regional programs -Independent evaluation

11 More Information: http://www.cms.hhs.gov/medicarereform/ccip/

12 1 2 3 45 6 7 8 9 1.Humana 2. Aetna 3. Lifemasters 4. McKesson 5. CIGNA 6. VNSNY/UHCS 7. Health Dialog 8. XLHealth 9. American Healthways CHF Prevalance Medicare (non-HMO) Medicare Chronic Care Improvement Programs

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