Medicare Faces Challenges Caring for Chronically Ill

"Both these programs had good relationships with local hospitals and with patients' physicians," Brown said. "The care coordinator knew the physicians, because they were either located in the same facility or the physicians set aside space for the care coordinator to interact with patients when the patients came in for a visit. They bumped into each other a lot."

Overall, however, the picture was not a positive one.

"It is discouraging. I think there's good reason to be skeptical of what these stand-alone disease-management companies can do," Precht said. "The record is mixed, but it's pretty clear, they don't save money."

More information

There's more on specific programs at the Medicare Web site.

SOURCES: Randall Brown, Ph.D., vice president and director, health research, Mathematica Policy Research Inc., Princeton, N.J.; Paul Precht, director, policy and communications, Medicare Rights Center; Feb. 11, 2009, Journal of the American Medical Association

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