This just out today from the CBO. The post is short, and encapsulates everything you need to know. I suggest you read it.
In brief, if you wish to look to CMS for serial, value enhancing demos, you might be disappointed:
Here is the lowdown:
Demonstrations Face Significant Challenges
Demonstrations aimed at reducing spending and increasing quality of care face significant challenges in overcoming the incentives inherent in Medicare’s fee-for-service payment system, which rewards providers for delivering more care but does not pay them for coordinating with other providers, and the nation’s decentralized health care delivery system, which does not facilitate communication or coordination among providers. The results of those Medicare demonstrations suggest that substantial changes to payment and delivery systems will probably be necessary for programs involving disease management and care coordination or value-based payment to significantly reduce spending and either maintain or improve the quality of care provided to patients.
Thud.
On another note, after a brief hiatus, I will be back to my regular posting routine shortly.
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