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Author: Barriers to improving quality exist in demonstration projects

Quality Improvement Monitor, May 5, 2005

Demonstration projects such as those ordered under the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 often fail to show cost containment or quality improvements because they assume that small investments and adjustments in practice can quickly result in big savings, according to an aritcle on the Health Affairs Web site.

Marsha Gold, a senior fellow with Mathematica Policy Research, reviewed demonstration projects under the Program for Elders in Managed Care, the first program authorized by the California HealthCare Foundation. In 1998, the program began issuing grants to managed care organizations, providers, and community organizations to demonstrate ways to improve care for chronically ill seniors through case management or disease management.

But the demonstration grantees failed to show results because of flaws in their concepts and problems in executing programs, the article says. For example, the $1 million grants for three years offered under the program were small compared to the revenue of large healthcare organizations, the article says.

Project grantees often defined their success as the ability to yield big results quickly, such as improving health status, reducing utilization, or cutting costs, which are difficult to demonstrate.

Read the article at www.healthaffairs.org.

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