Hard To Save Money With Chronically Ill

Hard To Save Money With Chronically Ill

A three-year experiment to see whether Medicare could prevent expensive hospital visits for people with chronic conditions like congestive heart failure and diabetes has suggested that such an approach may cost more than it saves. The program failed to meet the financial target of an overall savings to Medicare of 5%.

In the experiment, nurses periodically placed phone calls to patients to check whether they are taking their drugs and seeing the right doctors. The idea is that keeping people healthier can help patients avoid costly complications. But the preliminary findings indicate that the government is unlikely to save money. Medicare says the experiment has not reduced medical bills enough to offset the cost, as much as $2,000 a year for each patient.

Experts say that Medicare was too optimistic about how easy it would be to prevent costly complications and hospital visits by patients who are very sick. The experiment’s nurses spent most of their time on rudimentary issues, like directing someone to a specialist to get better care, although “numerous diabetics didn’t even know what an endocrinologist was.” Medicare signed up patients who were much sicker than they had expected, and most of the patients were already so ill that it was no longer a preventive program.

Some health care experts say Medicare should seek other ways of managing the care of the chronically ill, like the development of so-called “medical homes,” where a doctor with a team of other professionals oversees a patient’s care. A few doctors’ groups involved in a separate Medicare experiment have reported some

Whatever happens with this particular program, Medicare says it wants to keep experimenting. “We’re not giving up on this stuff,” said a Medicare spokesman. “We definitely want these programs to work.”

Source: New York Times