Overall health care spending growth is “historically slow” for the fourth year in a row. The Congressional Budget Office just reduced $222 Billion in previously projected 2020 Affordable Care Act costs. After five straight years (2007-2011) at about 19 percent, Medicare’s 30-day, all condition readmission rates are on pace to drop for two years in a row. Could the cost curve be bending?
Everyone seems to have a different answer. For those who cite “the patent cliff” and the Great Recession as the cause, the answer is no. For others who point to provisions of the Affordable Care Act and shifts in health care practice, cost growth is legitimately slowing and acceleration of changes will continue to bear fruit. As usual, disagreement is the coin of the health care realm.
The reality is that any emerging and defining truth is consistently hard to see in a system as multi-layered, intertwined and serpentine as health care has become over the past 50+ years. What we can do is gain confidence from across-the-board changes (e.g. Medicare readmissions declined in every state except Utah – already claimant of the lowest readmission rate in the country), stay skeptical about over-interpreting good news (various groups have modeled the relative impact of the patent cliff and the recession as being strongly explanatory), and focus on changes that make sense to increase quality, improve patient experience and deliver better outcomes while creating opportunities to lower cost.