2013
Following is an excerpt from an article about how an Accountable Care Organization was “so successful” in saving money. Don’t get me wrong I am all for changes in the delivery of health care not so much with saving money as the primary goal, but to make it better and more efficient for patients (saving money would be nice too). Whether the ACO is the answer remains to be seen. Remember, experts thought the answer was HMOs and ACOs are even less managed care, at least in theory; patients don’t even have to stay within the ACO to receive care.
In any case, we need to keep this savings stuff in perspective. $1.7 million may be a lot of money, but when you spread it across 17,000 patients it comes to $100 a piece. You could save that much and a lot more just by switching one prescription to a generic drug. In addition, we don’t know the system and other costs for achieving those savings.
Hey, by all means keep trying, but let’s not start crowing about success until we count all our chickens. It seems to me that will require not Accountable Care Organizations, but Actually Coordinated Organizations.
One such organization – Dartmouth-Hitchcock – recently showed just how successful this model can be if relevant patient data is analyzed effectively. It was able to hit all 33 quality benchmarks in the first year of the Pioneer ACO Model, while saving $1.7 million over 17,000 patients enrolled in the ACO. What made them so successful at reigning in cost? It turns out they had a head start of seven years.
via Welcome to the stone age of healthcare analytics | Computerworld Blogs.
QUINNSCOMMENTARY 
So, if I understand the article correctly, they saved $100 compared to a set of benchmark accounts for meeting all 33 of their quality benchmarks as an ACO.
Dick that isn’t one brand to generic Rx, that isn’t even statistical “noise”.
The fact is they may have been wildly successful or a massive failure and my guess is that there is no statistical showing of causailty in any net savings – only a correlation. While I have no data/reports on this myself, it is the nature of government programs that they project a result and then gather reports that measure data elements that tend to confirm their desired results (think Medical Loss Ratios “success” as reported by HHS) instead of truly capturing data that would reflect results (health insurance company profits increased from 2010 to 2012 even though fewer individuals were actually covered by the plans).
When we see costs decline despite the aging of Americans and continued expansion in health technology (billed charges, utilization, negative outcomes, actual health premiums), we’ll all “know it when we see it” (to quote a famous supreme court justice).
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