New Medicare demo project focuses on chronic health care

Disease management firms are trying to prove themselves to doctors and Medicare officials through an upcoming demonstration program.

By David Glendinning, AMNews staff. March 14, 2005.

Washington -- Starting this spring, Medicare will contract with disease management companies in nine areas of the country in an effort to improve health outcomes for up to 300,000 beneficiaries with chronic diseases.

Some physicians remain concerned that the demonstration program will favor reducing utilization over improving health care quality. The companies are trying to convince doctors that everyone stands to benefit from their Medicare involvement.

Irvine, Calif.-based LifeMasters Supported SelfCare Inc. will be participating in two of the project's nine regional areas.

AMNews recently sat down with Christobel E. Selecky, executive chair of LifeMasters and the president of the Disease Management Assn. of America, to discuss the issues.

Question: The Medicare reform law of 2003 had a pretty significant disease management element in it. What was DMAA's role in that?

Answer: We embarked about four years ago on a program to try to educate Congress and the Centers for Medicare & Medicare Services about the benefits of disease management and to encourage them to experiment with it as they were looking at ways to keep their Medicare and Medicaid costs under control.

It was a long process, but she [House Ways and Means health subcommittee Chair Nancy Johnson (R, Conn.)] really got it. She was really a very strong advocate of at least experimenting with disease management. In the bill it says that if these programs are successful, it will be expanded to the whole Medicare population.