Care management for Medicare patients drives more than 50% of savings

High-risk patients enrolled in Medicare who complete care-management programs have substantially better outcomes and lower spending than those who are not involved in care management, according to an Evolent Health analysis. The research found that across three full-risk accountable care organizations (ACOs) the impact of care management in 2017 was $15.1 million, more than half of the $26.6 million in shared savings for the three ACOs.

Monthly costs for patients who graduated from care management programs were 22% lower than those who did not graduate or did not engage with care management at all.

Many care management programs use engagement as an indicator of success, yet this analysis shows that focus is misplaced: When patients engaged with care management but did not graduate, their 2017 spending was nearly identical to those who never engaged in the first place. Successfully meeting individual program goals and graduating is key to reduced health care utilization.