Final Report to Congress on the Informatics for Diabetes Education and Telemedicine (IDEATel) Demonstration, Phases I and II.

The IDEATel demonstration tested the effects of providing home-based telemedicine services to a large number of eligible Medicare beneficiaries who had diabetes and lived in medically underserved areas in New York City and upstate New York. This report updates two earlier reports to Congress and draws conclusions on demonstration impacts. The demonstration met the requirements set by Congress for implementation; however, as delivered, it was neither as intensive nor as technologically sophisticated as originally designed. The evaluation found IDEATel to be clinically effective in only one site and to have no effects on Medicare Total, Part A, and Part B expenditures or the use of expensive services, such as hospital care. The intervention’s costs were excessive (over $8,000 per person per year) compared to programs with similar-sized clinical impacts. Even if the intervention costs were halved and the program reduced hospitalizations by 50 percent (both unlikely scenarios), the program would still increase total costs to the government.