The Demonstration Projects Are Not Working
- A paper in Health Affairs (subscription required) released last week found that even “aggressive” improvements in performance measures by accountable care organizations caring for diabetic patients would result in minimal cost savings — and “after the costs of performance improvement, such as additional tests or visits, are accounted for,” those minimal cost savings could become cost increases.
- A recent analysis of North Carolina’s patient-centered medical home initiative found the program yielded no budgetary savings, contrary to expectations.
- More broadly, the Congressional Budget Office noted earlier this year in a major report that most Medicare demonstration programs over the past several decades have NOT saved money.
Source: Chris Jacobs.
I was under the impression that solvency through unspecified efficiency changes to Medicare were one of those jokes you had to be a bureaucrat to get.
Adherents find it hard to believe that the engineering approach to health care doesn’t save money when applied. They’d like to think that policy makers could provide a recipe that everyone uses and the results come out the same every time. The problem is: providers are not competing on any measure. They’re not tweaking their systems as the need arises. They are not at risk of being beaten in the marketplace and going out of business. If all these were a risk, there would be a better chance that at improving the efficiency of Medicare by providers all looking for small gains in efficiency at the margin.
Quelle surprise! Leave health care decisions where they belong…aka with patients and their doctors.
Interesting post!
I’ve said it before and I’ll keep saying it: ACOs are a virtuous idea, but have never been shown to be effective.
Any formula based reimbursement will not promote coordination of care or lower prices.
It’s time to start paying attention to the evidence and realize what does NOT work.