CMS extends demonstration with hope to improve cost to patients, create savings

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The Centers for Medicare & Medicaid Services (CMS) has granted three-year extensions, subject to certain conditions, to three participants in the Care Management for High Cost Beneficiaries Demonstration (CMHCB).

“We have been striving for years to find ways to improve the quality of care for Medicare patients through greater coordination in a way that would also save money for Medicare,” said CMS Acting Administrator Kerry Weems.

Care management for high-cost beneficiaries is a provider-based service to improve quality of care and reduce costs for fee-for-service beneficiaries who have one or more chronic diseases. The services support collaboration among participants’ primary and specialist providers to enhance communication of relevant clinical information, according to CMS. They are intended to help increase adherence to evidence-based care, reduce unnecessary hospital stays and emergency room visits, and help participants avoid costly and debilitating complications.

The extensions were awarded to Key to Better Health, a division of Village Health; Massachusetts General Care Management Program; and Health Hero Network, Health Buddy Project:

  • The Key to Better Health program of New York City provides targeted disease management for beneficiaries identified with chronic kidney disease.    
  • Massachusetts General Care Management Program of Boston provides integrated care management services through the use of practice-based case managers, individualized plans of care, 24-hour access to care managers, and EMRs.
  • The Health Hero Network’s Health Buddy program Bend, Oregon and Wenatchee, Wash., provides participants with telemonitoring devices for use in their homes to monitor symptoms, physical status and condition-specific knowledge.

By extending the demonstration for another three years and frequently evaluating their financial status, CMS said that each of the programs will have the opportunity to continue to impact their populations, maximize savings and assist the agency in determining the replicability of the programs.