General Surgery Coding Alert - 2004 Issue 1
Disease Management: TRIO OF HEALTH PLANS TAPPED FOR MEDICARE DM PILOT
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Article Overview
This article explains a CMS disease management pilot for Medicare beneficiaries and situates it within a broader set of Medicare demonstrations and initiatives. It is relevant to health plans, disease management vendors, pharmacy benefit partners, and coding or reimbursement professionals tracking Medicare pilot activity, service coverage concepts, and CMS policy direction.
Why This Topic Matters
The article shows how CMS is testing disease management models in Medicare and highlights potential implications for health plans, vendors, and providers involved in chronic care programs and related payment arrangements.
What You Will Learn
- The purpose of the Medicare disease management pilot described in the article
- Which organizations were selected to participate in the pilot
- What patient populations and geographic areas the pilot targets
- How the pilot fits into CMS’s broader disease management initiatives
Who Should Read This
- Health plans
- Disease management vendors
- Medicare policy analysts
- Reimbursement and coding professionals
- Pharmacy benefit managers
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