Reported outcomes from medical homes must be able to discern between true and preceived cost savings, and North Carolina is an example of what can go wrong
Yet healthcare expenses continue to rise. How can this be? The savings claimed for these initiatives are illusory, but usually all that is lost is the cost of the initiative itself.
Not so with patient-centered medical homes. Medical homes are the first innovation whose cost is high and whose implementation actually can increase costs far beyond the program itself. This is exactly what happened in the Community Care of North Carolina Medicaid medical home program.
REALITY CHECK
No one applied a "plausibility check" to curious findings of savings-findings at odds with common sense:
What could explain the difference between the actual results and the report? Actuaries rely heavily on trend assumptions, changes in which can swing outcomes. A journal article from the actuary indicates that "choice of trend has a large impact on savings." A valid analysis requires an understanding that trend is not a "choice."
A specific level of savings was achieved, and it's up to the evaluator to find it. Reliance on variables that depend on personal choice automatically invalidates any result, as any outcomes-numerate analyst knows.
Meanwhile, if initiatives and access decisions on this scale continue to be considered generally, the entire healthcare sector needs to learn how to analyze reported outcomes more critically in order to distinguish true cost savings from fallacious results.
Breaking Down Health Plans, HSAs, AI With Paul Fronstin of EBRI
November 19th 2024Featured in this latest episode of Tuning In to the C-Suite podcast is Paul Fronstin, director of health benefits research at EBRI, who shed light on the evolving landscape of health benefits with editors of Managed Healthcare Executive.
Listen
FDA Clears Phase 2 Trial of Cannabis in PTSD
November 20th 2024After a three-year negotiation, the FDA has dropped its objection to allowing patients to self-titrate dosing of smoked cannabis. But regulators want to see additional information about the device that will be used for inhalation.
Read More
In this latest episode of Tuning In to the C-Suite podcast, Briana Contreras, an editor with MHE had the pleasure of meeting Loren McCaghy, director of consulting, health and consumer engagement and product insight at Accenture, to discuss the organization's latest report on U.S. consumers switching healthcare providers and insurance payers.
Listen