A Great Experiment

Everybody wants it. Better health care results for less financial outlay, that is. It's so high on most people's lists that it pulls even in their estimation with the Holy Grail of health care: universal care.

This is why an examination of a demo project being run by the Centers for Medicare and Medicaid Services is well in order. While the results so far are neither large in scale nor conclusive, they do show a consistent trend in the desired direction. The approach is a logical one. They are trying to re-leverage the system of incentives used in health care.

The current incentive system is, as stated by George C. Halvorson, "perverse." This project is testing out a different approach, one in which incentives are are earned by hitting a series of quality benchmarks. There are ten group practices involved in the program.

Vi Anna Wilde Matthews of The Wall Street Journal's Health Blog:

The groups scored nearly perfectly on quality measures for diabetes, heart failure and coronary artery disease, with half achieving the targets for all 27 bogeys, and all of the groups meeting at least 25. But only four achieved the CMS efficiency targets and won the extra payments tied to saving the government money and achieving quality standards. See more details by clicking here.

The savings were measured in a typically convoluted way-– the doctor groups got the bonus if the growth of the demonstration participants’ Medicare costs was at least 2% slower than the growth for other beneficiaries in their geographic areas.

John Pilotte, the CMS project director for the pilot, told the Health Blog he felt the savings results were still “very positive,” and better than the first year, when just two groups achieved the goal. Still, he added, “it sort of underscores the challenges and the difficulties in managing care for the Medicare population.”

Nothing is perfect and all things take practice. With the program still in its early phases but already showing measurable improvement, I would say this is one worth watching.

SOURCE: "In Experiment, Doctors Save Medicare Money While Improving Care" 08/15/08
photo courtesy of takomabibelot, used under its Creative Commons license