decisionhealth Newsletters, Part B News - 2004 Issue 4 (April)
Chronic Care Pilot Geared Toward Large Groups
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Article Overview
This article covers a CMS chronic care pilot tied to Medicare policy and disease management, with emphasis on who may apply, how the pilot is structured, and what general financial and performance expectations apply. It is relevant to large physician groups, disease management organizations, home health agencies, and other Medicare stakeholders evaluating whether the initiative fits their capabilities and risk tolerance.
Why This Topic Matters
The pilot is aimed at large organizations that can manage substantial numbers of chronically ill Medicare patients and absorb potential financial risk. Understanding the program’s basic structure helps organizations assess whether participation could align with their care management resources and business strategy.
Article Sections
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Program overview and purpose
Introduces the CMS chronic care pilot and summarizes its general purpose within Medicare policy and disease management. Provides context for the initiative and the type of organizations it is intended to reach.
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Participation requirements and eligible patients
Describes the kinds of organizations and patient populations associated with the pilot, along with the scale of participation expected. Also notes the broad categories of partners that may be involved.
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Financial structure, monitoring, and program outcomes
Outlines the pilot’s payment approach, reporting framework, and performance monitoring at a high level. Covers the general areas CMS will use to evaluate participation and program results.
What You Will Learn
- How the CMS chronic care pilot is framed and why it was created
- What types of organizations and patient populations the pilot is aimed at
- How the pilot’s general payment and evaluation structure is described
- What broad Medicare policy and disease management issues the article highlights
Who Should Read This
- Physician group administrators
- Medical coders and revenue cycle professionals
- Health system leaders
- Disease management organizations
- Home health agencies
- Medicare policy stakeholders
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