CMS takes a closer look at DSM

Sunday, May 4, 2003

May 5, 2003

WASHINGTON - CMS continues to show interest in disease state management as a way contain healthcare costs.

On May 29, CMS closed a request for proposal for its Capitated Disease Management Demonstration.

Later this summer, CMS will initiate a population based DSM demonstration that mirrors its existing fee-for-service reimbursement model.

CMS already has two DSM demonstrations underway.

CMS’s interest in DSM as a way to control healthcare costs pleases DMS proponents. They would, however, like to see the government adopt DSM without delay.

“If disease management is going to work in the Medicare world, and the entire (DSM) industry thinks it will, do you craft a demonstration project, award it, let it run for three years, evaluated and in six to seven years start to derive benefits,” said Bob Stone, executive vp of American Healthways, once of the nation’s largest providers of DSM services. “Or, if you really think it will work, do you do it now and not pursue the demo?”

That questions, stone said, has become a “meaningful part” of the congressional debate around Medicare reform going in Washington.

“The evidence is there (that it works),” Stone said. “Whether the evidence is there to satisfy the government, remains to be seen.”