Medicare DSM Programs Might Not Reduce Costs, Congressional Budget Office

Sunday, October 17, 2004

October 18, 2004

WASHINGTON - There is "insufficient evidence" to back up assertions by some lawmakers and health experts that disease management programs will reduce Medicare spending, according to a Congressional Budget Office report released last week. 
According to the report, the results of research on disease management programs are "mixed” and do not prove that additional screening, monitoring and educational efforts can lower overall Medicare spending by reducing use of acute care services.
"The few studies reporting cost savings generally do not account for all health care costs, including the cost of the intervention itself," the study says.
The CBO also contends that those studies that do indicate a benefit of DSM do not accurately reflect issues that would arise when applying the programs to the older and sicker Medicare population.
The report, which examined programs for congestive heart failure, coronary artery disease and diabetes, came one year after lawmakers included a provision in the Medicare Modernization Act to create a pilot program to evaluate whether preventive efforts can improve clinical results and decrease costs.
In a letter to Senate Budget Committee Chair Don Nickles ,R-Okla., the CBO said it would continue to monitor new research on disease management, including the results from the Medicare pilot programs. If the pilot programs are successful, DSM could become a permanent part of Medicare.