Medicare Disease Management Program Fails!



According to a NEJM study, commercially-run disease management programs within Medicare neither improved the quality of care nor produced any cost savings in a randomized study.  There was only significant improvements in only 14 of 40 pilot groups.  Reductions in patient care expenditures did not come near the $400 million in fees Medicare paid to the commercial operators.  How much more evidence do we need to prove that this trend is a joke?    These companies used nurse-based call centers to assess the needs of patients with diabetes and/or heart failure.   Before the evaluations could be even completed,  5 of the 8 companies incurred such financial hardships that they had to terminate the program!   And yet we move full steam head around the country with quality metrics, pay-for-performance programs, and disease managements,  all not only unproven but with more and more evidence showing that they are worthless.  Even worse these programs separate doctors from the real authentic work they need to do.  Please make it stop.  My head hurts.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  1 comment for “Medicare Disease Management Program Fails!

  1. Ben Van Raalte
    December 7, 2011 at 10:44 am

    Why were they allowed to terminate? So they had losses. We physicians suffer losses on cases that Medicare states get one fee for a complicated surgery, and on HMO’s that underpay. When they make out like bandits they keep the money.

    I find it interesting that private industry is allowed to terminate when they lose money, but physicians dont have such an option.

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