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Integrated Telehealth And Care Management Program For Medicare Beneficiaries With Chronic Disease Linked To Savings

Laurence C. Baker1,*, Scott J. Johnson2, Dendy Macaulay3 and Howard Birnbaum4 + Author Affiliations 1Laurence C. Baker is chief of health services research, a professor of health research and policy, and a CHP/PCOR fellow at Stanford University, in California. 2Scott J. Johnson is a manager at Analysis Group, in Boston, Massachusetts. 3Dendy Macaulay is a manager at Analysis Group, in New York City. 4Howard Birnbaum is a principal at Analysis Group, in Boston.

Treatment of chronically ill people constitutes nearly four-fifths of US health care spending, but it is hampered by a fragmented delivery system and discontinuities of care. We examined the impact of a care coordination approach called the Health Buddy Program, which integrates a telehealth tool with care management for chronically ill Medicare beneficiaries. We evaluated the program’s impact on spending for patients of two clinics in the US Northwest who were exposed to the intervention, and we compared their experience with that of matched controls. We found significant savings among patients who used the Health Buddy telehealth program, which was associated with spending reductions of approximately 7.7–13.3 percent ($312–$542) per person per quarter.

These results suggest that carefully designed and implemented care management and telehealth programs can help reduce health care spending and that such programs merit continued attention by Medicare. Meanwhile, mortality differences in the treatment and control groups suggest that the intervention may have produced noticeable changes in health outcomes, but we leave it to future research to explore these effects fully.

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