A leading cause of illness, disability and death among healthcare consumers, chronic disease claims a disproportionate share of costs for the elderly and generates a heavy financial burden on the nation as a whole. Now more than ever, health plans and providers are seeking strategies to balance the healthcare equation. Medicare disease management (DM) programs have emerged to even the odds, and have already demonstrated positive impacts on patients’ health status and spending.
This special report, "Medicare Disease Management: Tactics to Improve Health, Education and Independence in
an Aging Population," highlights challenges and opportunities in working with the Medicare population, strategies to close gaps in care, and steps for sustaining system change and improved outcomes within senior care communities.
Report contributors Blake Andersen, president, Chronic Care Group, Health Sciences Institute, Pamela Fromelt, vice president of government programs, LifeMasters Inc. and Dr. Randall Krakauer, national medical director, retiree markets, Aetna, provide inside details on how disease management programs can serve the needs of Medicare beneficiaries with chronic conditions to improve their health status, while reducing spending on these conditions.
This 41-page report is based on a spring 2006 audio conference, "Medicare Disease Management: Identifying and Engaging the Elderly Population To Improve Chronic Health Status."
Table of Contents
- Analysis: Demography, Geography and Risk
- Bridging Gaps Across Care Settings
- The Real Question: Does It Work?
- Barriers to Quality Improvement
- Applying Lessons Learned
- Case Study: LifeMasters Braces for Aging Baby Boomer Impact on Health System
- Inside LifeMasters’ Medicare Programs
- A Laundry List of Challenges
- Advantages of Working with the Medicare Population
- Key Strategies for Success
- Case Study: Aetna Identifies Disparities in Senior Care
- A Model for Development
- Characteristics of the Medicare Population
- Creating an Inclusive Program
- An In-Depth Look at Medicare Health Support
- Staff Ratios for Medicare Populations
- Early Results Pave Road to the Future
- Q&A: Ask the Experts
- Identifying Risk in the Medicare Population
- Predictive Modeling Techniques
- Strategies for Enrollment and Engagement
- The Cost of Medicare DM
- Assessment Tools & Techniques
- Meeting Consumer Demand
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Glossary
- For More Information
- About the Authors
