Medicare Cost-Cutting Projects Flunk

February 26, 2009
Special Feature

An ambitious Medicare cost-cutting program aimed at keeping elderly patients out of the hospital hasn�t done a very good job, according to a study published in the Journal of the American Medical Association.

An ambitious Medicare cost-cutting program aimed at keeping elderly patients out of the hospital hasn’t done a very good job, according to a study published in the Journal of the American Medical Association. Of 15 programs set up around the country, only 2 actually reduced the number of times Medicare patients went to the hospital, and none saved the federal program any money. The study points up the difficulties the Obama administration may face in changing the healthcare system for an aging nation.

The problem, according to those who evaluated the programs, is that the programs involved changing ingrained habits of both patients and doctors, a pair of difficult tasks. Patients needed to make lifestyle changes—stop smoking, lose weight, eat healthier foods, and get more exercise—all of which can be difficult to accomplish. Doctors needed to be open to nurses acting as liaisons between them and their patients.

The 15 test sites involved in the study each developed their own programs, which tracked more than 18,300 Medicare patients between 2002 and 2007. Of the 15, the two that managed to cut down on hospital stays featured far more frequent one-on-one contact between the individual patient and a nurse than the others. The nurses offered counseling on healthier life styles, tracked medications, and helped patients understand and follow their doctor’s advice. One of these programs cut hospital stays by 17% and the other by 20%, giving Medicare officials hope that future reform efforts that follow these examples may be more successful.