The Department of Health and Human Services' plan to ensure quality care for high-risk Medicare beneficiaries--while, in turn, save money--has yet to deliver on some of its key goals.
As part of the Affordable Care Act, HHS created a $10 billion innovation lab over 10 years as an experiment for federally run health centers. The goal was to have 90 percent of participating clinics obtain full accreditation as a patient-centered medical home. However, HHS fell short of this goal--only 69 percent did so, according to a new report from the RAND corp., which was commissioned by the Centers for Medicare & Medicaid Services.
The report finds that the experiment did not achieve the savings for which HHS had hoped. In fact, emergency room visits increased in centers participating in the experiment.
The experiment meant to send extra money to community health centers. There, case managers would focus on individuals with chronic conditions, such as diabetes, and ensure they take care of themselves and stay out of the hospital.
However, as RAND finds, it's possible that directing funding in this manner may have actually caused a spike in costs, as the clinics were designed to care for lower-income individuals.
Despite the report's findings, industry experts are wary of the early results.
"It would be a mistake to say we can conclude that the medical home model does not work," Marshall Chin, M.D., a professor at the University of Chicago medical school who reviewed drafts of the RAND study, tells Kaiser Health News.
HHS' experiment has been met with skepticism in the past. Critics have worried about its cost-effectiveness and whether the program will actually end up saving money in the long-term, FierceHealthPayer previously reported.