More than 100,000 Now in Pilot Medicare Health Support Programs

BALTIMORE–More than 100,000 Medicare beneficiaries are now
participating in the voluntary Medicare Health Support programs
designed to reduce health risks and improve the quality of life for
chronically ill patients, CMS said last week.

“With more than 100,000 people with Medicare already
participating, we expect to learn about how we can support the best
possible quality of care for our beneficiaries with chronic
conditions,” said CMS Administrator Mark McClellan.

According to the agency, chronic conditions are a leading cause
of illness, disability and death among Medicare beneficiaries and
account for a disproportionate share of health care expenditures.
For example, about 14 percent of Medicare beneficiaries have
congestive heart failure, but they account for 43 percent of
Medicare spending. About 18 percent of Medicare beneficiaries have
diabetes, yet they account for 32 percent of Medicare spending.

Commonly, beneficiaries who live with multiple chronic
conditions have heavy self-care burdens and experience poor health
outcomes, increased costs and diminished quality of life, despite
the best efforts of their physicians and other health care
professionals, a CMS statement said. The agency added that there is
evidence that self-care support, education and assistance in
coordinating care for people with these conditions can be effective
in improving clinical outcomes, reducing their health care costs
and improving participant and provider satisfaction.

Medicare Health Support connects program participants with
specially trained health professionals. The eight pilot programs
offer guidance and other support to help these chronically ill
beneficiaries manage their health, adhere to their physicians’
plans of care and reduce their health risks. The organizations’
interventions include personalized care plans, the use of biometric
monitoring devices (for weight, blood pressure and pulse), 24-hour
telephonic nurse access and group education and support
sessions.

Congress created the Medicare Health Support programs as part of
the Medicare Modernization Act and the pilots were announced in
December 2004.

“Medicare Health Support is an innovative approach to care that
represents a key priority for the future of Medicare,” said
McClellan. “We are committed to improving the quality of care and
quality of life for chronically ill beneficiaries, leading to fewer
complications and overall health care cost savings.”

Using historical claims data, CMS identified beneficiaries in
the pilot regions who are candidates for Medicare Health Support.
More than 160,000 beneficiaries have been invited to participate in
the programs, which began operations between August 2005 and
January 2006. The first programs have been operational less than
six months and have been met with positive response from
beneficiaries, their caregivers and physicians, CMS said. Medicare
Health Support programs are operating in the following regions:

–Oklahoma (LifeMasters Supported Selfcare, Inc.) started Aug.
1, 2005
–Washington, DC & Maryland (American Healthways, Inc.) started
Aug. 1, 2005
–Western Pennsylvania (Health Dialog Services Corporation) started
Aug. 15, 2005
–Mississippi (McKesson Health Solutions, LLC) started Aug. 22,
2005
–Northwest Georgia (CIGNA Healthcare) started Sept. 12, 2005
–Illinois (Aetna Health Management, LLC) started Sept. 1,
2005
–Central Florida (Green Ribbon Health) started Nov. 1, 2005
–Tennessee (XLHealth Corporation, Inc.) started Jan. 16, 2006

More information about the program is available at www.cms.hhs.gov/CCIP/.