HCP Professor, John Z. Ayanian, MD, MPP assessed the policy implications of a comprehensive evaluation of 15 programs designed to improve the coordination of care for over 18,000 high-cost Medicare beneficiaries with major chronic conditions, such as heart disease, lung disease and diabetes. With monthly fees of $60 to $268 from the Centers for Medicare & Medicaid Services (CMS), these programs trained nurse care coordinators to provide health education and support to patients, typically by telephone. “The financial and clinical results of this careful evaluation were sobering,” wrote Dr. Ayanian. 

Only 1 of 15 programs had a significant reduction in hospitalizations over 4 years of follow-up, and the programs had only sporadic effects on quality of care and health outcomes. Ayanian noted that the study offered important insights to guide Medicare policy going forward, including the need for care coordinators to interact in person with chronically ill patients and to collaborate more closely with primary care and specialist physicians who are directly responsible for patients’ care.

The editorial was published in the February 11 issue of JAMA and reported in the on-line edition of the Wall Street Journal.