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Medicare Tests Chronic Care Management Fee : Projects seek to strengthen the relationship between chronically ill patients and their doctors.


 

The ACP's white paper cited several studies from the Institute of Medicine, Rand Corp., and CMS, indicating that care for chronically ill patients was fragmented and costly because of a lack of coordination under fee-for-service. This makes the large-scale testing of a patient-centered chronic care model “crucial to the health system's viability.”

Key elements of Dr. Wagner's model include:

▸ Mobilizing community resources to meet patient needs—for example, encouraging patients to participate in effective community programs.

▸ Reorganizing the health care system to encourage open and systematic handling of errors and quality problems to improve care and providing incentives to improve quality of care.

▸ Empowering and preparing patients to manage their health and health care, emphasizing the patient's central role in managing their health.

▸ Ensuring the delivery of effective clinical care and self-management support, such as providing clinical case management services for complex patients and giving care that patients understand and that fits with their cultural backgrounds.

▸ Promoting clinical care that's consistent with scientific evidence and patient preferences, embedding evidence-based guidelines into daily clinical practice.

▸ Organizing patient and population data to facilitate care, such as identifying subpopulations for proactive care, and sharing information with patients and providers to coordinate care.

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