Locally, much has been made about the Massachusetts Patient-Centered Medical Home Initiative, with supporters claiming it will revolutionize medicine. It is too early to tell for sure, but will it save money?
North Carolina started down this road before Massachusetts, and while early reports claimed historic savings, recent evaluations have called that conclusion into question. Al Lewis over at The Health Care Blog as some takeaway lessons.
The ongoing saga of savings estimates for the Community Care of North Carolina (CCNC) patient-centered medical home (PCMH) is finally over. The verdict: no savings. Because the scale and visibility of the CCNC experiment are unparalleled in the Medicaid sector today, it is important that the right policy and delivery system lessons be learned from this dispositive conclusion.
Lesson 1: Enhancements in access do not necessarily create cost reductions, at least in Medicaid.
Lesson 2: Perhaps it is time to create an ER co-pay for Medicaid recipients that has more than one digit to the left of the decimal point.
Lesson 3: Never assume that if an actuarial consultant says something saved money, they must be right because they are actuaries. Use your own judgment to determine if a claim of savings is plausible.
Lesson 4: Don’t stop experimenting
Local leaders and policymakers should be carefully watching experiments like the one in North Caroline, not only to enhance our own efforts, but to make sure we will not make some of the same mistakes.
The media should pay close attention in order to ask well informed questions of our public leaders, especially when they make historic and revolutionary claims of future savings in health policy.
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