Friday, January 14, 2011

The Mass General Care Management Program

In 2005, the Mass General Integrated Care Management Program was one of six demonstration projects selected by the Centers for Medicare and Medicaid Services (CMS) to lead the way in shaping a new model of care that might help improve the health of the sickest 15 percent of Medicare patients, who account for more than 75 percent of the nation's health care costs.

Now in its fifth year, independent evaluation has found that the program has demonstrated substantial success in improving care for thousands of its sickest patients – reducing hospitalization, emergency room visits and mortality rates, among other achievements – while reducing Medicare costs by as much as 7 percent.

The program has achieved its success through nurse case managers, who act as the point of access to care for each patient. These nurse case managers work closely with patients and their loved ones, serving as liaisons between the patient and other members of the care team, monitoring the patient's health needs with home visits, office appointments and phone calls, and responding to those needs through customized health care plans and input from the program's other staff, including social workers, pharmacists and community resource specialists.

The Mass General Care Management Program was launched in August 2006 with 2,500 high-risk Medicare patients. In 2009, because of its preliminary success, the hospital was granted an extension to continue the program for another three years, and approximately 750 new patients were added. The program also has been expanded to two other Partners HealthCare institutions: Brigham and Women's Hospital and the North Shore Medical Center, and is estimated to increase to about 8,300 total patients across all three sites.

The program at Mass General is led by Gregg Meyer, MD, senior vice president for the MGH/MGPO Center for Quality and Safety; Tim Ferris, MD, MPH, medical director of the MGPO; and Eric Weil, MD, associate chief for Clinical Affairs for the MGH General Medicine Unit and MGPO associate medical director for Primary Care.

The Case Management Program team.

Media coverage:

American Case Management Association, Fall 2010

The Boston Globe, May 17, 2009

Internal coverage:

MGH Hotline, Oct. 1, 2010

Caring Headlines, Nov. 5 2009

MGH Hotline, Feb. 13, 2009

Learn more about the CMS Demo project:

View statistics about the program prepared by the Research Triangle Institute, an independent evaluator, or view a two-page summary of the report.

View an article about the CMS demo published by the National Academy of Sciences.

For media requests, contact the Public Affairs Office.

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