Medicare patients could see better care

Since the passage of the Affordable Care Act in 2010, the administration has been designing new programs and underwriting experiments to come up with alternate payment models.

Last year, 20% of traditional Medicare spending, about $72 billion, went to models such as accountable care organizations, or ACOs, where doctors and others band together to care for patients with the promise of getting a piece of any savings they bring to Medicare, administration officials said.

There are now 424 ACOs, and 105 hospitals and other health care groups that accept bundled payments, where Medicare gives them a fixed sum for each patient, which is supposed to cover not only the initial treatment for a specific ailment but also all the follow-up care.

It is still too early to know whether these alternate payment models improve health of patients and whether the savings that have been achieved so far, often by focusing on the most expensive patients, will plateau. Studies on the success of these programs have shown mixed results.

“We still have very little evidence about which payment methods are going to be successful in getting the results we want, which are better quality care and more affordable care,” said Suzanne Delbanco, executive director of Catalyst For Payment Reform, a California-based nonprofit that has been tracking the spread of alternative payment models in the private sector.

“We’re just wanting to avoid a situation where a few years from now, where we’ve completely gotten rid of fee-for-service,” Delbanco said. “We don’t want to wake up and say, ‘Oh my gosh, we did it and we’re no better off.'”

CNN