Bending The Cost Curve: From Demos To Pilots
September 24th, 2009
by
Chris Fleming
|
There has been much debate about whether the various health reform bills being debated in Congress contain enough measures to reform the health care delivery system and slow the rate of growth in health care spending. Speaking at the Sept. 9 briefing held to release Health Affairs’ Sept-Oct issue, a thematic volume titled “Bending The Cost Curve,” Center for Studying Health System Change President Paul Ginsburg cited one subtle but arguably important sign of progress: The movement from “demonstration” projects to “pilot” projects.
“The bills have real reforms in getting right the structure of relative payments under fee-for-service, and they do take some initial steps toward broader payment units,” Ginsburg said. “The bills talk about pilots which is real progress compared to a couple of years ago when policymakers talked about demonstrations. They talk about a lot more authority for [the Department of Health and Human Services] to run with these pilots – should they work – and expand them.”
Later, Ginsburg expanded on the demonstration/pilot distinction: “A demonstration is a research study: It has an end date, providers are recruited for a certain period of time. A pilot is really an initial step to a policy: It will be watched closely, and if it appears to be working it will be expanded, meaning that you can invest in it and take it much more seriously.”
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