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.