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Disease Management Program Proves Effective for Improving the Outcomes of Medicaid Beneficiaries

The Virginia Department of Medical Assistance instituted a disease state management program for its Medicaid fee-for-service patients. The program aimed at identifying opportunities for significant improvement among patients with at least one of five chronic conditions, including, diabetes, depression, hypertension/congestive heart failure, asthma/chronic obstructive pulmonary disease, and gastro-esophageal reflux disease (GERD)/peptic ulcer disease (PUD). The physicians and pharmacists of 35,628 patients received notifications about practice guidelines, feedback based on claims data, a clinical summary of clinical measures, and the latest results on a quarterly basis for three years. 5995 physicians and 1410 pharmacists participated in the program. Compared to a matched control group, the intervention group had better health outcomes, less unnecessary medical utilization (ER, hospital, and office visits), lower healthcare costs, and less adverse drug events. Disease management programs that target educating physicians and pharmacists may be effective at improving health and cost outcomes in a population of Medicaid patients.

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For more information, you can find the full study in the journal, Health Policy

CITATION: Zhang, N. J., Wan, T. T., Rossiter, L. F., Murawski, M. M., & Patel, U. B. (2008). Evaluation of chronic disease management on outcomes and cost of care for Medicaid beneficiaries. Health Policy, 86(2), 345-354.