I commend you, Mr. Chairman, for scheduling this timely hearing about care coordination and disease management programs. Disease management programs, if implemented thoughtfully, can truly improve the health outcomes for Medicaid patients. The question we must ask is whether disease management programs should be privately run. Can private disease management programs improve health and save money at the same time? Or, like some managed care programs, will they save money at the expense of patient care?

We have learned that private disease management organizations which contract with state Medicaid programs can create great savings for the state. We must ask whether a state that developed and administered the disease management program itself would create greater savings. What kind of profits do private disease management organizations make? Is there an incentive for private disease management organizations to skim the easy dollar savings off the top by implementing minor changes and then moving on to new states? Are these organizations creating disease management models that can create sustained profits and show continued health improvement?

Some states, such as North Carolina and Indiana, have created very promising programs within the fee-for-service landscape. We will hear from the experts on these programs today. I understand that these Medicaid programs worked closely with the state departments of health, local community resources, physicians and other healthcare providers to create comprehensive and responsive disease management networks. These networks can reach Medicaid populations that may not have a phone or even the money to pay for fruits or vegetables as a part of their diet.

We must identify programs that will increase the quality of care for Medicaid beneficiaries, and if they can also save the Medicaid programs money, so much the better. But disease management programs should not be a code word for privately-run systems that reduce patient care in order to increase profits.

I thank all the witnesses for coming to share your experiences with us regarding care coordination and disease management within the Medicaid program. The experiments being conducted in the various states will help us improve care for Medicaid patients.