Apr 23, 2019

A reality check on value-based health care reform

two doctors operating

Photo: Ricky Carioti/The Washington Post via Getty Images

There was a telling exchange in this month’s meeting of the Medicare Payment Advisory Commission that pours some cold water on the fervor to move toward a system that pays hospitals and doctors for how well they take care of patients, instead of how many tests and services they order.

Driving the news: MedPAC was weighing a proposal that would force all doctors to participate in a Medicare accountable care organization. A transcript of the meeting, flagged by the Health Care Blog, revealed that health economist and MedPAC vice chairman Jon Christianson was worried about that idea.

  • "There is not strong evidence that [Medicare Advantage plans and ACOs] have or can reduce costs for the Medicare program or improve quality … But somehow we are assuming that whatever we do going forward, that will change," he said.

The bottom line: We are still in a nascent stage of new health care payment models, but it's not a slam dunk they will meaningfully lower costs or improve quality.

Go deeper: The Trump administration's new primary-care payment models

Go deeper