About CMS Care Management for High-Cost Beneficiaries Demonstration.

CMS selected the ACCENT (Advancing Chronic Care through E*Health Networks and Technologies) consortium to lead the Health Buddy Program. The consortium is made up of: Health Hero Network, American Medical Group Association, Bend Memorial Clinic and Wenatchee Valley Medical Center.

Centers for Medicare and Medicaid Services (CMS) selected six projects under the Care Management for High-Cost Beneficiaries Demonstration in July 2005. The CMS initiative will test approaches for transforming how doctors and hospitals provide care for high-cost Medicare patients with severe, complex chronic conditions. The goal is to improve the quality of life for these patients while significantly reducing costs.

The Health Buddy Program is one of the six projects. It is notable among awardees because it will be conducted across multiple sites and because of its robust use of health information technology.

CMS is requiring that Care Management for High-Cost Beneficiaries Demonstration awardees demonstrate improvements in the quality of care for high-cost Medicare patients who represent most of the program's expenditures. Awardees are guaranteeing to CMS that they will save at least 5 percent of the total Medicare costs for the patients assigned to them.

Beneficiary participation in the programs will be voluntary and will not change the amount, duration or scope of participants' fee-for-service Medicare benefits. Fee-for-service Medicare benefits will continue to be covered, administered and paid under the traditional fee-for-service Medicare program. The Health Buddy Program will be offered at no charge to the beneficiary. Organizations chosen for the demonstration will not be able to restrict beneficiary access to care or restrict beneficiaries to a limited number of physicians in a network.