Jon Skinner Rebuts Critics of the Dartmouth Atlas

Mon, 15 Jun 2009 15:17:25 +0000

Writing at Economix, my colleague Jonathan Skinner answers the criticisms of using the Dartmouth Atlas studies of health care spending variation as a basis for policy reform (see this post from last week). From his fourth point, on what to do about regional variation:

The critics are also right to be worried that simply cutting reimbursement rates won’t turn an expensive and fragmented health-care system (like Miami’s, with 2006 Medicare costs of $16,351 per person), into an efficient, integrated system of care (like that of Grand Junction, Colo., with costs of $5,873). How then can regional systems of care be transformed? One proposal is to establish accountable care organizations, or A.C.O.’s. These are physician-hospital networks designed to encourage providers to coordinate care, improve quality, and share some of the resulting savings. Elliott Fisher of Dartmouth and Mark McClellan of the Brookings Institution have argued that this is the key building block for any health-care reform.

You can also see Jon discussing these ideas as part of this Rockefeller Center panel (his talk starts about an hour into the program).