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Other testimony proposals, however, especially those focused on Medicare, carry the risk of distracting us from more important changes. Chronic care coordination (including the medical home model) has not yet convincingly been demonstrated to cut costs. Accountable care organizations (this year’s buzz-phrase) require more willingness to cooperate than many providers have so far shown. Bundled hospitalization payments make good sense but require the same kind of willingness to cooperate. Tying payments to quality introduces questions of data interpretation and validity of guidelines.
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