The Centers for Medicare and Medicaid Services approved 3 demonstrations projects to study health outcomes along with and economic costs of health management for ESRD patients who were enrolled in these projects (the intervention cohort) compared to populations that were not enrolled in the demo projects (the other cohort). The Evaluation report for the first 3 years of the 5 years demonstration projects in its entirety is found here.
The results were mixed - both in terms of health outcomes and cost savings.
The question is does disease management not work for ESRD populations or was there something wrong with the demo intervention designs (study design error) which caused these results?
I hope and believe that ESRD health management interventions can be designed to improve health outcomes for patients and also be (at least) budget neutral.
Practices from a country such as Italy which has much better ESRD health outcomes (See an older post here where this is discussed) should be used here in the U.S. to improves our ESRD health outcomes.
Also, we can study physicians and medical centers in the U.S. who have better than expected health outcomes with their ESRD populations and transfer their practices and protocols to the rest of the healthcare professionals who treat ESRD populations so that a ESRD health management intervention can designed which imoroves both the life expectancy and quality of life of the ESRD population in the U.S.
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