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27 Health Care Financing Review 1 (2005-2006)

handle is hein.usfed/hhcrefngrv0027 and id is 1 raw text is: U.S. and German Case Studies in Chronic Care Management: An Overview Stuart Guterman In December 2004, the Bertelsmann Stiftung, The Commonwealth Fund, and AcademyHealth jointly sponsored a confer- ence in Berlin, Germany on Case Studies in Chronic Care Management. This confer- ence assembled representatives from the U.S. and German Governments, several organi- zations that had developed chronic care management initiatives in the two countries, and other health care and policy experts to discuss clinical, organizational, and financ- ing issues. The case studies discussed at the conference are presented in this issue of the Review; this article describes some relevant considerations that are common to the U.S. and German health systems. OVERVIEW The differences between the U.S. health care system and those of other industrial- ized countries are well established, but attention primarily has focused on the higher level of spending in the U.S., the reasons that the U.S. spends more, and the absence of better quality of care corre- sponding to the high level of spending (Anderson et al., 2005). These are all sig- nificant issues, but an important aspect of international comparisons is to identify common problems in different countries and how each of these countries deals with these problems. Several recent studies have focused on these similar problems across countries, which open the door to The author is with The Commonwealth Fund. The statements expressed in this article are those of the author and do not nec- essarily reflect the views or policies of The Commonwealth Fund, AcademyHealth, or the Centers for Medicare & Medicaid Services (CM S). developing common approaches to improv- ing the quality of health care (Hussey et al., 2004; Schoen et al., 2004). The Berlin conference on Chronic Care Management brought together a group of officials representing policymaking organi- zations1 in the U.S. and Germany and indi- viduals who participated in the planning and implementation of chronic care man- agement initiatives in the two countries. The conference participants discussed those initiatives and their experiences, and were able to identify common features and dimensions along which the two countries differ and the lessons that can be drawn from them, and discuss their implications for policies to improve health care in both countries. This overview provides a context for those articles, by describing some relevant considerations that are common to the U.S. and German health systems, and how the two countries can learn from the experi- ences related in the case studies. This overview concludes by describing how the issues raised by the German case studies, which included initiatives developed by both public and private organizations, and the U.S. case studies, all of which described initiatives in the private sector, can be applied to the context of the U.S. Medicare Program. 1 The Bertelsmann Stiftung aims to identify social problems in a broad range of areas and use and generate knowledge and expertise to develop and implement model solutions; the Commonwealth Fund has a mandate to promote a high per- forming health system by supporting independent research on health care issues and makes grants to improve health care practice and policy; and AcademyHealth supports health ser- vices research promoting its use in public and private decision- making. HEALTH CARE FINANCING REVIEW/ Fall 2005/ Volume 27, Number1 1

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