In this holiday season, it is a time for giving presents and our latest Potpourri presents you with many gifts of health information, including some positive news about an ACO program, some cautions for the success of ACOs, an apparently successful disease management program, lung cancer screening, earnings growth for physicians and other health professionals and lessons in bundled payments.
Bundled payments are designed to change the incentives for providers so that they manage patient care in a more cost-effective manner, hopefully without negatively affecting quality. A report from the Agency for Healthcare Research and Quality examines the research evidence to date on the effect of bundled payment approaches, finding that spending and utilization are probably lower, with an uncertain effect on quality.
Under the Premier program, launched July 23, participants will share best practices and data with other members, and focus on improving care and reducing costs in hip/knee replacement, lumbar spine fusion, coronary artery bypass graft, heart valve replacement, percutaneous coronary intervention, and colon resection.
Another excellent paper from the Congressional Budget Office is issued, this one on Medicare’s demonstration projects on value-based payments to providers. Once again, the demonstrations had very mixed results, with only one demonstration generating savings for the Medicare program.
Another excellent draft report from the Agency for Healthcare Research and Quality reviews the evidence related to the effects of bundled payments to providers on quality and costs. The evidence, while weak, suggests that utilization and costs decline and quality is not notably affected in either direction.