Medicare Compliance & Reimbursement

One provider set to sign up 30,000 beneficiaries.

If you are a provider frustrated by dealing with tough diseases such as diabetes and advanced-stage heart disease, then a new demonstration project from Medicare may offer the answer.
 
The Centers for Medicare and Medicaid Services' new Disease Management Demonstration will aim to develop new methods to work with sicker populations. CMS just announced a three-year contract in Florida with disease management provider LifeMasters, which will enroll up to 30,000 Florida beneficiaries. Under the project guidelines, patients will receive their normal doctors' services along with disease management.

Separately, CMS will roll out disease management projects in nine locations in 2005 as part of its Chronic Care Improvement Project (CCIP), which will affect approximately 180,000 beneficiaries. Contractors, which include LifeMasters in Oklahoma and McKesson Healthcare in Mississippi, will receive higher payments if they improve clinical quality or beneficiary satisfaction, and also if they reduce costs for their target populations, as compared to a control group.

If the CCIP is successful, CMS has the option to expand the program into more regions or even nationally.

For more information on the Florida project, go to www.cms.hhs.gov/medlearn/matters/mmarticles/2005/SE0519.pdf. For more on the CCIP, go to www.cms.hhs.gov/medicarereform/ccip/.