Quality of Methods and Strength of Evidence for Disease Management Evaluation
Coordinating Primary Care with Disease Management
Improving the Outcomes of Disease Management
Evaluation of a Multi-Disciplinary Model for Coordinating Primary Care
with Disease Management
Principal Investigator: Peter J. Fagan, Johns Hopkins University
This study will evaluate the impact of a new model to integrate third-party care management processes with physician group practices. The model combines a physician pay for performance program with an enhanced nurse care management program and is being implemented in five physician group practices in partnership with HealthSpring (a third-party payer) and American Healthways (a disease management firm). Under this arrangement, a dedicated care management nurse will be located at each practice site with another dedicated nurse at the American Healthways’ call center. Participating physicians will be eligible for performance bonuses of up to 20 percent based on 25 quality indicators.
The research team will evaluate the impact of the new model compared with conventional disease management for Medicare beneficiaries using a two-group, quasi- experimental study. For each intervention site, the investigators will select two comparison practices yielding a total of 5 intervention practices (50 physicians and 5,000 patients) and 10 comparison practices (100 physicians and 10,000 patients).
The study will examine changes in utilization, expenditures, and quality metrics over a 24-month period. In addition, participating physicians and nurses will be interviewed to assess their perceptions of the strengths and weaknesses of this approach.
This study is printed in Health Services Research.
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