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John Houle said...
I’ve been reading some of the testimony on delivery system reforms from the House Ways and Means Committee meeting earlier this month, in particular the lengthy statements from MedPAC Chairman Glenn Hackbarth and Urban Institute Senior Fellow Dr. Robert Berenson.
KEVIN LAKE said...
Hackbarth and Berenson are each distinguished health care figures, and their remarks are worth careful study. Together, they paint an all too familiar gloomy picture of a system whose costs are out of control, in which quality is often poor, and where there is little correlation between expenditures and outcomes. Few would disagree with the causes that they identify: payment structures that reward volume, lack of coordination among providers, an overemphasis on specialty care, and a system that seems more often driven by supply than demand.
Nancy W. Denig said...
Perhaps .. Who among us is immune to the disease!
Eric J. Becker said...
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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Timothy G. Coleman said...
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How long had your medical blog?
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