Effects of Non-Face-to-Face Chronic Care Management on Service Utilization and Outcomes Among US Medicare Beneficiaries with Diabetes

• Published in: Journal of general internal medicine : JGIM 2024-08, Vol.39 (11), p.1985-1992
• Main Authors: Hong, Dongzhe, Stoecker, Charles, Shao, Yixue, Nauman, Elizabeth, Fonseca, Vivian, Hu, Gang, Bazzano, Alessandra N., Kabagambe, Edmond K., Shi, Lizheng
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Beneficiaries; Cardiovascular diseases; Chronic conditions; Chronic Disease; Chronic illnesses; Congestive heart failure; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - economics; Diabetes Mellitus, Type 2 - therapy; Fee-for-Service Plans; Female; Government programs; Health care; Health services utilization; Heart failure; Heart rate; Humans; Internal Medicine; Male; Medicare; Medicare - statistics & numerical data; Medicine; Medicine & Public Health; Mortality; Original Research; Patient Acceptance of Health Care - statistics & numerical data; Patients; Pharmacists; Primary care; Regression analysis; Regression models; Retrospective Studies; Terminology; United States - epidemiology; Utilization
• ISSN: 0884-8734; 1525-1497; 1525-1497
• DOI: 10.1007/s11606-024-08667-0

Background Type 2 diabetes mellitus (T2DM) results in heavy economic and disease burdens in Louisiana. The Centers for Medicare and Medicaid Services has reimbursed non-face-to-face chronic care management (NFFCCM) for patients with two or more chronic conditions since 2015. Objective To assess the impacts of NFFCCM on healthcare utilization and health outcomes. Design, Setting, and Participants This retrospective cohort study included Medicare fee-for-service beneficiaries with T2DM and at least one additional chronic disease between 2014 and 2018. Exposures At least one record of NFFCCM Current Procedural Terminology codes. Main Measures The health outcomes in the study included major adverse cardiovascular events (MACE), all-cause mortality, and heart failure. The monthly service utilization and continuity of care index for primary care were also included. The propensity score method was used to balance the baseline differences between the two groups. Weighted multivariate regression models were developed using propensity score weights to assess the impacts of NFFCCM on outcomes. Key Results During the 5 years of study period, 8415 patients among the 118,643 Medicare beneficiaries received at least one NFFCCM. Patients receiving any NFFCCM had reduced healthcare utilization compared with patients not receiving NFFCCM, including 0.012 (95% CI − 0.014 to − 0.011; p