Programs
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Topic |
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General Information
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Category |
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Medicare Modernization Act
CCIP
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Date Created |
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| 03/25/2004 02:09 PM |
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Date Updated |
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| 04/20/2004 03:24 PM |
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Why were CHF, diabetes and COPD selected as threshold conditions? |
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Question |
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Why were CHF, diabetes and COPD selected as threshold conditions for the Chronic Care Improvement Programs? |
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Answer |
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Initially, the programs will be focused on beneficiaries who have congestive heart failure (CHF) and complex diabetes, or chronic obstructive pulmonary disease (COPD) because these beneficiaries have heavy self-care burdens and high risks of experiencing poor clinical and financial outcomes. Individuals diagnosed with CHF, complex diabetes, and COPD disproportionately consume health care resources and account for a high prevalence within the Medicare population. Beneficiaries who live with these conditions often have other co-morbidities. Commonly, beneficiaries who live with multiple chronic illnesses interact with the health care system in a fragmented way, which often leads to poor health outcomes, increased cost, and dissatisfaction, despite the best efforts and intentions of providers. There is evidence that self care support, education, and other tools targeted at beneficiaries with these conditions are particularly effective at improving clinical outcomes, reducing overall cost, and improving beneficiary and provider satisfaction.
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