Summary
This report, conducted by the UCLA Center for Health Policy Research, presents the findings of a comprehensive evaluation of the California Department of Health Care Services' Disease Management Pilot Program (DMPP). DMPP was a three-year effort to deliver disease management services to Medi-Cal beneficiaries suffering from asthma, congestive heart failure, diabetes and other chronic conditions who were not enrolled in managed care plans.
The evaluators found that the program successfully enrolled 94 percent of the eligible population and engaged about 10 percent, who were at medium or high level of risk for adverse events such as hospitalization, in more active management of their condition. In a few instances and for some beneficiaries with specific conditions, reductions in hospitalizations and emergency department visits and improvements in quality of care and member satisfaction measures were observed. However, the evaluators did not find a consistent pattern of change in the overall rates of utilization, quality of care, or member satisfaction during the program and in comparison to Medi-Cal enrollees in the control group. Furthermore, the retrospective analyses of the program expenditures did not indicate a reduction, even though prospective analyses had indicated the likelihood of program savings. Lack of intensive follow-up and inadequate data raised questions as to whether such interventions can have an impact on both patient health and program costs.
Publication Authors:
- Gerald F. Kominski, Ph.D.
- Nadereh Pourat, PhD
- Dylan H. Roby, PhD
- Ying-Ying Meng, DrPH
- Allison L. Diamant, MD, MSHS
- Anna C. Davis
- Wenjiao Lin, MS
- Ana E. Martinez, MPH
- Christina M. Kinane
- Xiao Chen, PhD
- Gregory Watson, MS
- Stefanie J. Brown , MPP
- Jenna Jones, MPH