WSJ Blog: Medicare Tries to Cut the Cost of Complex Patients
Medicare is trying new tactics to cut costs for complex patients and keep them healthier, although some health-policy observers say they don’t go far enough.
Under the 2010 health overhaul law, the agency is giving health-care providers incentives to band together and coordinate care for groups of patients. If their costs fall by a great enough percentage, the providers get to pocket some of the savings.
Another part of the law will allow Medicare to impose financial penalties on hospitals that readmit high numbers of patients within 30 days of discharge. Readmissions like these often signal a preventable post-hospital complication. Federal officials are working to help hospitals reduce infections and other ailments that patients acquire inside hospitals by 40% over a three-year period under a piece of the law.
“Better quality care with fewer complications is actually less expensive,” says Paul McGann, a deputy chief medical officer at the Centers for Medicare and Medicaid Services innovation center.
Past efforts by Medicare to coordinate care have yielded little, if any, savings. A report by the nonpartisan Congressional Budget Office this year found that Medicare paid 34 programs over a decade to coordinate care or provide disease management. The efforts, on average, had no effect on Medicare expenditures or hospital admissions, the report found.