“The spillover savings in Medicare that we found suggest that at least some of the interventions providers adopted […] changed the way care was delivered for all patients,” assistant professor J. Michael McWilliams, said in a news release […]The findings “suggest that provider groups are willing—and able—to make systemic changes that result in higher-value care for patients across the board.” And that means they’ll likely be willing to enter into similar contracts with additional insurers, which could mean a rapid transition to coordinated care throughout the system.
The rosy picture painted by thus study is complicated, however, by the rest of the data out there. The most systematic study to date of the 32 ACOs from the Obamacare pilot program found that only slightly more than half of the ACOs saved money for their patients, and that two decided to drop out of the program altogether. But the problem with ACOs is not just that the data is, so far, inconclusive; it’s that the theory behind them is ultimately provider-centric, arguing that if we want to control costs we have to pursue technocratic tinkering on the provider side of health care rather than shifting more responsibility to the consumer.This “provider-oriented approach” involves massive and growing government intervention. In theory, government regulations empower consumers by pressuring providers on their behalf, but in practice, all too often in our corrupt, lobby ridden system the regulators and regulation writers are bent in the direction of serving vested interests and producers. Empowering consumers by actually empowering consumers ensures that the system is being policed not by an easily corruptible, monolithic regulatory regime in DC but by millions of people who have a vested interest in getting the best services for the best price.