Chronic Disease Management in Ru

The purpose of the proposed research will primarily focus on Medicare and Medicaid chronic disease management (“CDM”) programs serving rural and nonrural patients, but will also examine CDM outcomes in programs serving private insureds and the uninsured. The project is a follow-on to two prior ORHP-funded projects on Disease Management. In Year-3 the DM research team will be applying lessons learned in Year-1 and Year-2 to the analysis of Medicare and Medicaid disease management patients as well as uninsured and private health insurance DM programs. Our analytical efforts will be primarily focused on diabetes and CHF because these two diseases are most commonly included in disease management programs and are responsible for both high expenditures and patient care costs when not well controlled (CDC, 2002). Recent CDC estimates of the direct and indirect costs associated with diabetes is that diabetics alone account for nearly $100 billion in health-related costs in the United States per year (CDC, 2002). Similarly, health costs associated with cardiovascular disease are estimated at approximately $300 billion per year (CDC, 2002). In the face of ever-increasing costs for chronic disease care, Medicare and Medicaid programs have begun focusing on disease management methods as a pro-active, capitated form of healthcare, which has been demonstrated to improve the health of chronically ill individuals and reduce overall program care costs. Medicare and Medicaid services are offering inducements, such as higher capitated payments, to managed care programs, which build in DM programs for beneficiaries with conditions such as diabetes, CHF and/or stroke (DHHS, 2003).

Bolin, J.N., Gamm, L.D., Kash, B.A., and Peck, B.M. (December 2004). Chronic disease management in rural areas: Rural and Nonrural Differences in Managed Medicare and Medicaid Programs. Final draft report to the Office of Rural Health Policy. College Station, TX: The Texas A&M University System Health Science Center, School of Rural Public Health, Southwest Rural Health Research Center. DOWNLOAD FULL REPORT (PDF)