Why Care Management Isn’t Cost-Effective

I am going to do a couple of health care related posts.  Because I know most of the readership is here for CV-19 info, I will try to explain the backdrop to these.  Typically there are a number of topics that I focused on in the health care posts.  One was the widely promoted idea that if we had intensive care management it would not only improve patients’ health outcomes, but would lead to lower spending.  But it costs something to engage in this more intensive care management, and the reality is that most people don’t have huge health spending, so the possibility of a return on the care management investment over a significant-sized population is dubious.  And that is what the research has continually shown.  But investors keep plowing money into care management companies, now under the guise of “digital” health.

This study looked at whether oncology practices that participated in a Medicare program to optimize cancer care saved money.  In general there was no difference in quality, utilization or experience of care outcomes.  There was a savings of about $300 per cancer episode, but that savings did not even cover the cost of the the extra care management work or performance bonuses to the practices.  Total cost was higher, but you didn’t get better outcomes.  Some wellness or care management programs do appear to improve outcomes, so at least you would feel like it was worth paying for the extra effort, but here the outcomes were similar, so why pay more?  (JAMA Article)