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Arbor Research presented key findings from an analysis of the CMS-run Disease Management Demonstration for ESRD Patients at the AcademyHealth Annual Research Meeting in Seattle. This demonstration was evaluated from 2006 to 2008 to test the effectiveness of disease management provided to ESRD patients enrolled in Medicare Advantage plans offered by three organizations in 19 geographic areas.

Arbor Research analysis found that two dialysis organizations in the Disease Management Demonstration group showed improvements in patient survival. There was no evidence of a reduction in hospitalization; however, one organization demonstrated marginal improvements in hospitalization over time. For all three organizations, skilled nursing facility stays and physician visits were consistently reduced. At least one organization in the demonstration achieved cost savings.

While the research did not reveal meaningful changes in quality of life for patients in the demonstration, high satisfaction was observed among patients who remained in the demonstration. Sources of high satisfaction had to do with specific care services provided by the organizations. Nurse care manager and medication-related support services had the greatest positive effect on satisfaction, according to patients. Confusion and billing issues were the most commonly cited reasons for disenrollment. Some evidence suggested disenrollment may be related to poor health, with sicker enrollees more likely to drop out of the demonstration.

The Arbor Research study team suggests that the findings have implications for the ongoing assessment of the value of disease management, especially as disease management is considered as a potential component of care delivery in Accountable Care Organizations (ACOs).

Inquiries to:
Katherine Pearson
Communications Coordinator
Arbor Research Collaborative for Health
(734) 369-9639
communications@ArborResearch.org