Reduced Health Care Costs Associated With Disease Management for Chronic Heart Failure: A Study Using Three Methods to Examine the Financial Impact of a Heart Failure Disease Management Program Among Medicare Advantage Enrollees

BackgroundDisease management (DM) for chronic heart failure (CHF) has been examined in several randomized clinical trials. Most have shown improvements in quality and cost reductions. However, there is only limited information about the financial impact of CHF DM outside of research settings.Methods and ResultsThree commonly employed observational study methods (pre-post comparison, comparison of intervention patients to a convenience cohort and comparison of intervention patients to a propensity matched cohort) were used to assess the financial impact of DM for CHF for Medicare Advantage enrollees over different 1-year periods between 2001 and 2004. DM was associated with savings ranging from $318 to $708 per patient per month. Most savings appeared to be associated with reduced expense for hospitalizations and exceeded the cost of providing DM.ConclusionCHF DM savings repeatedly demonstrated in randomized clinical trials are achievable in commercial insurance settings and exceed the cost of the intervention. Given the widespread interest in addressing the rising cost of health care, CHF DM remains an important consideration for Medicare beneficiaries.