Posting date: July 30, 2003

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Health Affairs, 10.1377/hlthaff.w3.342
Copyright © 2003 by Project HOPE

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Population-Based Disease Management Under Fee-For-Service Medicare

¹ Sandra M. Foote directs the Health Insurance Reform Project at the George Washington University in Washington, D.C.

^*Corresponding author.

Abstract

Medicare policymakers are considering testing population-based disease management (PDM) programs under fee-for-service (FFS) Medicare as a way to improve health and cost outcomes for selected subgroups of chronically ill beneficiaries. This paper provides a brief overview of how PDM programs are evolving in the private sector and describes how they differ from other approaches already being tested in Medicare disease management demonstrations. It also discusses some key opportunities and issues to be considered in adapting PDM programs for testing in the FFS Medicare context.

Key Words: Health Promotion/Disease Prevention, Chronic Care, Health Spending Prevention, Medicare, Quality Of Care

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