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COPYRIGHT 2003 Eli Research, Inc.
This is the first in a Perspectives series on disease management that M&H will publish periodically over the next several weeks.
If the Medicare prescription drug bill finally sinks in ideologically troubled waters, down with the ship will go a major initiative to push forward disease management and related techniques throughout the Medicare program.
The Centers for Medicare and Medicaid Services is committed to exploring wide-scale implementation of DM, and several demonstration projects already are in progress or well developed on the drawing board. But both the House and Senate versions of Medicare drug legislation contained additional authorizations to speed up study and implementation.
"The most exciting thing about the prescription drug bill is that it will bring disease management into Medicare," said Medicare conferee Rep. Nancy Johnson (R-CT) at a Nov. 6 Capitol Hill forum sponsored by the American Association of Health Plans.
Implementing DM program-wide is imperative for maintaining Medicare's fiscal viability as well as beneficiaries' health, said Johnson. "If we don't focus on this concept, we won't be able to prevent all the diabetics from becoming dialysis patients."
But it's "very hard for the government to legislate prevention," and in some ways DM goes. against the grain of the way medicine is practiced in America, Johnson suggested. "Other countries have a smaller number of people going into dialysis because they manage disease differently than we do."
Nevertheless, some private-sector player have become "very good at ... incentivizing prevention," she said, and the lessons should be transferred to Medicare.
Any bill that is enacted will certainly contain at least...
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