The Washington Post: Medicare wants to better coordinate care. Here’s why that could be difficult

Aside from expanding coverage, one of Obamacare’s main goals is to better coordinate care, with the idea of lowering costs and producing better health outcomes. A new study hints at challenges that could undermine those efforts.

The Affordable Care Act encourages the formation of Medicare Accountable Care Organizations, which are provider networks that are financially incentivized to keep down costs and keep patients healthier. That means there should be a pretty significant effort across the ACO provider network to ensure that care is being properly coordinated. In short, the theory here is that when doctors talk to each other and share the same goals — which is not always a given — patients get better care and costs are kept down.

One possible problem, according to a new study in JAMA Internal Medicine: Coordination could be difficult because of how fragmented care is in the existing Medicare program.

To make this point, Harvard Medical School researcher J. Michael McWilliams and some colleagues looked at Medicare claims and physician rosters for 2010 and 2011, the two years just before the Medicare ACO program launched. McWilliams studied how Medicare beneficiaries sought out care and whether they were going to providers that would eventually be within the same ACO. (The more patients staying within the ACO, the better chance participating providers will have to meet program goals.) In short, the research essentially imagines the ACOs were in place in 2010 and 2011, using data from 525,000 beneficiaries across 145 provider groups that eventually formed ACOs. 

Continue reading here: http://www.washingtonpost.com/blogs/wonkblog/wp/2014/04/21/medicare-wants-to-better-coordinate-care-heres-why-that-could-be-difficult/

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