U Penn / Wharton health policy gurus Lawton Burns and Mark Pauly are doubtful, as expressed in a new article in Milbank Quarterly. It seems to be open access. Find it here.
- Policymakers seek to transform the US health care system along two dimensions simultaneously: alternative payment models and new models of provider organization.
- This transformation is supposed to transfer risk to providers and make them more accountable for health care costs and quality.
- The transformation in payment and provider organization is neither happening quickly nor shifting risk to providers. The impact on health care cost and quality is also weak or nonexistent.
- In the longer run, decision makers should be prepared to accept the limits on transformation and carefully consider whether to advocate solutions not yet supported by evidence.