Medicaid DM To Get Boost From CMS

The federal government plans to give Medicaid disease management a lift by matching the money states pay to run such programs.

“Disease management is an exciting opportunity to significantly improve the care delivered to Medicaid beneficiaries with chronic conditions,” said Dennis G. Smith, acting administrator of the Centers for Medicare & Medicaid Services when the effort was unveiled. (Mark McClellan has since been confirmed by the Senate.)

Smith continued: “It uses the best of managed care techniques of coordinating care that may not have been available in a fee-for-service delivery system.”

State Medicaid directors received a letter from CMS announcing the availability of the federal matching funds as well as information about what directors have to do to obtain them. “States may contract with a disease management organization (DMO) that would manage the overall care of the beneficiary, but does not restrict access to other Medicaid services,” the CMS says.

MANAGED CARE April 2004. ©MediMedia USA