Care Management in Germany and the U.S.: An Expanded Laboratory


The Issue

There have been varied attempts to manage care for those with chronic conditions in both Germany and the United States. In this Commonwealth Fund–supported study, researchers use case studies of three U.S. chronic care management models and four German models to examine their similarities and differences and glean lessons for both nations.

What the Study Found

Of the seven care management models, all but two drew on additional payments from outside the provider organization to finance the efforts. The models focus on people at different stages of their disease: some target those at high-risk for health complications, while others target healthier individuals with the potential to effectively self-manage their condition. The services provided range from physician role enhancement to patient education, remote monitoring, and care coordination.


The analysis highlighted differences that were greater among the seven models of care management within countries than between them. Care management models in both countries shared policy goals: establishing financing mechanisms; creating a focal point in the health care system through which to coordinate care across providers; and altering physician–patient relationships by empowering patients and educating providers.

Publication Details

Publication Date: April 25, 2011
Authors: Patricia M. Pittman, Ph.D., Sharon B. Arnold, Ph.D., and Sophia Schlette, M.P.H.
Summary Writer: Martha Hostetter
P. M. Pittman, S. B. Arnold, and S. Schlette, "Care Management in Germany and the U.S.: An Expanded Laboratory," Health Care Financing Review, Fall 2005 27(1):9–18.

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