Applying Disease Management Strategies to Medicare

Medicare coverage begins for many when they have already developed one or more chronic diseases, and it often pays for the latest and costliest phases. Population-based disease modeling, patient screening, and monitoring would be appropriate interventions for chronic renal disease. Patients who have...

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Bibliographic Details
Published in:The Milbank quarterly 1999-01, Vol.77 (4), p.461-484
Main Authors: Tompkins, Christopher P., Bhalotra, Sarita, Trisolini, Michael, Wallack, Stanley S., Rasgon, Scott, Yeoh, Hock
Format: Article
Language:English
Subjects:
Care and treatment
Chronic diseases
Chronic Illness
Chronic kidney failure
Chronically ill
Community Health Planning - organization & administration
Cost Control
Diabetes
Diabetic nephropathies
Dialysis
Disease Management
Disease models
Diseases
Economic aspects
Economic efficiency
Finance
Forecasting
Health care
Health Care Costs
Health conditions
Health economics
Health Education
Health planning
Health services
Humans
Information technology
Intervention
Kidney disease
Kidney diseases
Kidney Failure, Chronic - economics
Kidney Failure, Chronic - therapy
Long-Term Care - organization & administration
Mass Screening - organization & administration
Medical ethics
Medicare
Medicare - organization & administration
Modelling
Needs Assessment - organization & administration
Original
Payments
Practice Guidelines as Topic
Prevention
Preventive medicine
Primary Prevention - organization & administration
Public health
Quality Assurance, Health Care - organization & administration
Sociology
Sociology of health and medicine
United States
USA
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Summary:Medicare coverage begins for many when they have already developed one or more chronic diseases, and it often pays for the latest and costliest phases. Population-based disease modeling, patient screening, and monitoring would be appropriate interventions for chronic renal disease. Patients who have not yet advanced to end-stage renal disease would benefit from management of diabetes and hypertension, avoidance of nephrotoxic substances, and better preparation for dialysis. Administrative support could take the form of clinical guidelines, physician-led multidisciplinary teams, integrated delivery systems, provider and patient education, and new information technologies. Medicare reflects the long-term public perspective, and thus should further this new direction by supporting education, reimbursing for prevention efforts and allied health services, encouraging efficiency, and monitoring cost and quality outcomes.
ISSN:0887-378X
1468-0009
DOI:10.1111/1468-0009.00148