Case management for high-cost Medicare beneficiaries

Health Care Financ Rev. 1999 Summer;20(4):87-101.


We estimated the effects of three Health Care Financing Administration (HCFA)-funded case management demonstrations for high-cost Medicare beneficiaries in the fee-for-service (FFS) sector. Participating beneficiaries were randomly assigned to receive case management plus regular Medicare benefits or regular benefits only. None of the demonstrations improved self-care or health or reduced Medicare spending. Despite the lack of effects of these interventions, case management might be cost-effective if it includes greater involvement of physicians, is more well-defined and goal-oriented, and incorporates financial incentives to generate savings in Medicare costs. Models incorporating these changes should be investigated before abandoning Medicare case management interventions.

Publication types

  • Clinical Trial
  • Evaluation Study
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Case Management / economics
  • Case Management / organization & administration*
  • Centers for Medicare and Medicaid Services, U.S.
  • Data Collection
  • Fee-for-Service Plans / economics*
  • Health Care Costs
  • Health Services Research
  • Humans
  • Medicare / economics
  • Medicare / organization & administration*
  • Models, Organizational
  • Pilot Projects
  • Self Care
  • United States