Evaluation of the Medicare Care Management Performance Demonstration

Section 649 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 requires the Secretary of Health and Human Services to conduct the Medicare Care Management Performance (MCMP) demonstration. MCMP is a three year pay-for-performance demonstration program with physicians to meet the needs of eligible beneficiaries through the adoption and use of health information technology (HIT) and evidence-based guidelines for promoting continuity of care, helping stabilize conditions, preventing or minimizing acute exacerbations of chronic conditions, and reducing adverse health outcomes, such as adverse drug interactions due to polypharmacy. The target population for the demonstration consists of primary care physician practices with ten or fewer physicians, in up to four states, who treat FFS Medicare beneficiaries with diabetes, heart conditions, and/or other chronic conditions. The MCMP evaluation tasks include a comprehensive case study component to examine issues pertaining to the implementation and operational experiences of the participating practices, and an examination of the effect of financial incentives and use of HIT on care management, quality of care, and impacts on the use and costs of services.