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Evaluation of a Chronic Care Management Model for Improving Efficiency and Fiscal Sustainability

Overview
Specialty Public Health
Date 2024 Nov 21
PMID 39571131
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Abstract

Chronic care management is effective. Barriers to program durability include dependence on the provider-nurse duo to carry out labor-intensive services and the lack of a fiscally sustainable model. Between January and October 2022, an expanded chronic care management team-consisting of a provider, nurse, community health worker, and pharmacist-conducted a four-month intervention in an ambulatory setting. This intervention, using a convenience sample of 134 Medicare patients with uncontrolled type 2 diabetes or hypertension, demonstrated statistically significant improvements in controlling type 2 diabetes ( < .01) and blood pressure ( < .001). Direct provider workload decreased, and the Medicare reimbursement rate was 85.5%. (. 2025;115(2):133-137. https://doi.org/10.2105/AJPH.2024.307886).

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