Editorial: Learn from coordinated-care experiments before changing Medicare

Published Jan 17, 2014 at 12:01AM

Coordinated care is the new darling of health care reform, touted as the solution that will make us healthier and save money at the same time.

Oregon’s Democratic U.S. Sen. Ron Wyden thinks it’s the answer for reforming Medicare. He and three colleagues presented their bipartisan “Better Care, Lower Cost Act” Wednesday, focused on coordinating care for seniors with multiple chronic conditions.

Although the rationale behind coordinated care has significant appeal, it’s far from proven that it can achieve its goals. Oregon is currently engaged in a wide-ranging experiment with the concept, focused on patients in the Oregon Health Plan, the state’s version of Medicaid. Other efforts are underway in the Midwest and Northeast.

Participation in the program would be voluntary, according to the sponsors’ news release. Health plans and providers could create integrated care organizations that would receive a flat fee for each Medicare patient, rather than payment for individual services. Because 68 percent of Medicare patients have multiple chronic conditions, they could benefit from improved communication among providers in different specialties.

Wyden has credibility as an advocate for seniors, having launched his political career by helping start the Grey Panthers, a senior advocacy organization, before winning a seat in Congress in 1980. He has a reputation for working effectively across the political aisle and is garnering increased attention today because he is widely expected to be the next chairman of the Senate Finance Committee.

In presenting this new idea for Medicare, Wyden said it would be based on “pioneering practices” and would “break the government’s shackles on innovation.” His fellow sponsors said it would “unleash the creativity of the medical community,” “modernize Medicare to drive quality and lower costs” and help seniors “navigate a maze of health care providers.” It’s also envisioned as the solution to the severe financial challenges of the system as the Boomer generation ages into Medicare.

The goals are good and the method promising, but the data isn’t in yet on the multiple coordinated care experiments already underway. Let’s learn from those efforts before we toss another major part of our health care system into the chaos of change.