Chronic Disease Care

A chronic disease management program implemented by the Indiana Office of Medicaid Policy and Planning produced cost savings among Medicaid beneficiaries with congestive heart failure but had no significant financial impact for patients with diabetes, according to a study in Health Affairs.

In addition, the study found greater cost savings among low-risk congestive heart failure patients, who used a telephone intervention program, than high-risk congestive heart failure patients, who were treated through an intensive nurse care management program. According to the researchers, differences in effectiveness for high- and low-risk groups might reflect the difficulty of promoting use of medical services among very sick populations, as well as differences in the net impacts of the nurse care managers compared with the less-intense telephone intervention.

The authors wrote that concentrating disease management efforts on patients who are already likely to experience high use of services might not prove effective in reducing overall costs (Holmes et al., Health Affairs, May/June 2008).