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.
Briana Contreras, an editor of Managed Healthcare Executive, spoke with Fred Turner, CEO of Curative, in this month’s episode about the challenges middle-class Americans face in dealing with medical debt, exploring the causes behind it and the impact on overall health.
Listen
Bridging the Diversity Gap in Rare Disease Clinical Trials with Harsha Rajasimha of IndoUSrare
November 8th 2023Briana Contreras, an editor with Managed Healthcare Executive, spoke with Harsha Rajasimha, MD, founder and executive chairman of IndoUSrare, in this month's episode of Tuning in to the C-Suite podcast. The conversation was about how the disparity in diversity and ethnicity in rare disease clinical trials in the U.S. has led to gaps in understanding diseases and conditions, jeopardizing universal health, and increasing the economic burden of healthcare.
Listen