A Review of Healthways' Medicare Health Support Program and Final Results for Two Cohorts

Abstract

Chronic care management programs have been shown to offer a scalable approach for improving health and reducing health care costs in commercially insured populations. Medicare Health Support (MHS) was a government-sponsored program designed to determine whether that success could be translated to a Medicare fee-for-service population with complex chronic diseases. The purpose of this article is to provide an overview of MHS and its Phase I study design, and to review the officially reported outcomes of the arm of the study in which Healthways, Inc. provided program services. MHS employed a block randomized design; consent was requested after randomization and evaluation included all eligible individuals, irrespective of that consent. Healthways accepted 2 study cohorts. The first cohort included beneficiaries with diabetes and/or heart failure (Intervention, N=19,936; Control, N=9995) for a 3-year study period. The second cohort entered after 1 year and included beneficiaries with heart failure, with or without diabetes (Intervention, N=4238; Control, N=2106). Comparisons of total health care spending between the Intervention and Control groups found gross savings of $3.8 and $5.7 million for the first and second Intervention cohorts, respectively, and these savings exceeded program costs for the second cohort. Improvements in evaluated clinical measures were demonstrated in the first Intervention cohort, and overall program satisfaction was 94%. Clinical measures and satisfaction were not evaluated for the second cohort. These results indicate that Healthways successfully adapted its commercial chronic care management program for a Medicare fee-for-service population and achieved high satisfaction, improved clinical measures, and financial savings.