The Evaluation of the Medicare Coordinated Care Demonstration Findings for the First Two Years

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The Evaluation of the Medicare Coordinated Care Demonstration Findings for the First Two Years

Brown R, Peikes D, Chen A, et al. Mathematica Policy Research, Inc. The Evaluation of the Medicare Coordinated Care Demonstration: Findings for the First Two Years. http://www.mathematica-mpr.com/~/media/publications/PDFs/mccdfirsttwoyrs.pdf. Published March 21, 2007. Accessed December 11, 2014. This report synthesizes findings from the first 2 years of the demonstration programs operations, focusing on program impacts over the first year after enrollment for beneficiaries who enrolled during the first year, and over the first 25 months of operations for all enrollees. Findings presented include program-specific estimates of impacts on (1) survey-based measures of patients. health status, knowledge, behavior, satisfaction with their health care, quality of care, and quality of life; and (2) claims-based measures of patients. Medicare service use and expenditures, and the quality of care received. The report links differences across programs in these impacts to differences in the interventions and the target populations in order to draw inferences about .what works. and .for whom.. This synthesis of findings draws on an earlier report to Congress that described the types of programs and beneficiaries participating in the demonstrations, the interventions the programs have implemented, and how well patients and physicians like the programs (Brown et al. 2004). This report updates that information and adds analyses of Medicare service use and expenditures and a scoring methodology developed specifically for this evaluation to rate the quality of each program’s intervention on several dimensions. The findings in brief indicate that patients and physicians were generally very satisfied with the program, but few programs had statistically detectable effects on patients. behavior or use of Medicare services. Treating only statistically significant treatment-control differences as evidence of program effects, the results show: • Few effects on beneficiaries. overall satisfaction with care • An increase in the percentage of beneficiaries reporting they received health education • No clear effects on patients. adherence or self-care • Favorable effects for only two programs each on: the quality of preventive care, the number of preventable hospitalizations, and patients. well-being • A small but statistically significant reduction (about 2 percentage points) across all programs combined in the proportion of patients hospitalized during the year after enrollment • Reduced number of hospitalizations for only 1 of the 15 programs over the first 25 months of program operations • No reduction in expenditures for Medicare Part A and B services for any program

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