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Confronting the Barriers to Chronic Care Management in Medicare

Published: January 2003

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Confronting the Barriers to Chronic Care Management in Medicare By: Berenson RA and Horvath J Published In: Health Affairs (Web Exclusive)	Quantity

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This paper examines the ability of the current Medicare program—both traditional fee-for-service and risk-based contracting—to address the needs of beneficiaries with chronic conditions, who represent almost 80 percent of program enrollment. Grounded in indemnity insurance principles, including concerns about “moral hazard,” the traditional Medicare program faces difficulty evolving to support of a chronic care model of health care practice. Although capitation may be the most desirable platform to support provision of
care to beneficiaries with chronic conditions, the current structural limitations and problems faced in the Medicare+Choice program limit capitation's use at this time.

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