December 6-8, 2004
Experiences and Challenges in the Coordination of Chronic Care in the U.S. and Germany: A Bilateral Exchange
Sponsored by The Commonwealth Fund and the Bertelsmann Foundation

AcademyHealth, The Commonwealth Fund and the Bertelsmann Stiftung partnered to promote bi-lateral exchange on health policy challenges between Germany and the United State. Despite the differences in these two health systems, many of the challenges they face are similar. Aging populations and the growing prevalence of chronic diseases, rising health care costs, difficulties in standardizing clinical care and avoiding medical errors, are but a few of the topics demanding urgent policy responses. Indeed, researchers and policymakers are currently experimenting with similar solutions.

On December 6-8th, 2004 in Berlin, Germany, an expert meeting was held on the topic of Coordination of Chronic Care. Germany is the first country to have legislated disease management as part of a national health reform. The 2001 legislation called for additional compensation for sickness funds and patients participating in disease management programs, and was conceived as part of a risk adjustment strategy to assist those funds with the highest percentage of chronically ill and elderly. To date, national standards have been issued for diabetes type II, breast cancer and coronary heart disease, and are now under development for diabetes type I, asthma, and chronic obstructive pulmonary disease. As implementation moves forward, the Germans have expressed interest in understanding U.S. operational and evaluation experiences.

In the United States, disease management programs have become increasingly prevalent among commercial and public health plans. As health care expenditures continue to rise in the U.S., policymakers are seeking information on what elements of these strategies are actually reducing costs and improving the quality of care. In this context, U.S. experts are also eager to learn more about the German experience.

Twelve high level researchers and decision-makers from the U.S. joined a similar number of colleagues in Germany to discuss three case studies of successful chronic care management models from each country. In addition to analyzing the strengths of each of the models, workshop participants used the differences between the German and U.S. experiences to reflect critically on their own assumptions and practices.

A report on the meeting will be available soon.