Apr 23, 2019

A reality check on value-based health care reform

Bob Herman

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

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A reality check on value-based health care reform

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