One of the few things that brings a divided Washington, D.C., together is the Nationals baseball team. Both Congress and the new administration could learn a thing or two from the Nats -- or any baseball team, for that matter -- when it comes to streamlining the federal government's bloated health care bureaucracy.
Imagine the Nationals sign a highly touted player -- perhaps not a power hitter, but one who promises to consistently get on base.
Yet instead, the player consistently strikes out, not even batting .100. Worse, he somehow negotiated a bloated, ever-expanding contract, so his costs mount even as his performance deteriorates. And he's a cancer in the dugout -- he ignores coaches and fans, and pushes the boundaries with management.
The Nationals would cut him loose in a heartbeat.
Reformers in Congress and DOGE now face a similar scenario. For the past 15 years, a highly touted player -- the Center for Medicare and Medicaid Innovation (CMMI) -- has been promising to save taxpayer money and improve the nation's two largest healthcare programs, but has been failing spectacularly.
Simply put, it's time to send CMMI into retirement.
CMMI was created to test new ideas and models for delivering lower-cost, higher-quality care to seniors, the disabled, and low-income Americans. To conduct their work, CMMI received $10 billion in funding in 2011, and another $10 billion in 2020. In fact, every 10 years, the agency will get another $10 billion of our money.
Independent analysis from the Congressional Budget Office illuminates the full scope of CMMI's excess and inefficiency. From 2011 to 2020, the agency spent $7.9 billion to develop and administer alternative reimbursement models that "saved" $2.6 billion -- meaning that the agency's efforts cost taxpayers over $5 billion in total.
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Going forward, CBO estimates CMMI's efforts will increase net federal spending by $1.3 billion over the next decade.
These costly at-bats -- all funded with taxpayer dollars, mind you -- often fail by CMMI's own standards. The agency has tested 49 different models since its inception, and only four met the criteria for expansion. That's an 8 percent success rate. There are pitchers with better batting averages.
A review of the agency's biggest experiments reveals the same pattern over and over -- high price tags without real improvements for patients.
The Affordable Care Act created Medicare Accountable Care Organizations, or ACOs, which are combinations of doctors and hospitals held accountable to cost, quality, and health results for patients. The idea is that when health providers collaborate and are at risk for outcomes, they will lower costs. Doctors and taxpayers share in the savings if an ACO lowers costs. In theory, this is a great idea that was touted when Obamacare was passed as the way care would become affordable and outcomes would improve.
In 2023, the program saved just 0.2 percent of total Medicare spending. And many beneficiaries don't even know they are in an ACO because Medicare often randomly assigns them. Patients also don't share in any savings an ACO may produce -- that is only shared between taxpayers and ACO care providers.
CMMI began testing variations of ACO models and wants all Medicare beneficiaries in these or another value-based model by 2030.
Recent CMMI pilot programs also require doctors to collect data on, and intervene against, housing, food, transportation, and other economic insecurities. The theory is that these social issues impact health in negative ways, so physicians should be mobilized against people's ills that may be out of their control. Physicians collect data every six months and then determine an appropriate intervention. The problem? The data is so high-level that it's difficult to design a solution. Collecting it once every six months makes it useless for evolving problems. A person struggling with food or rent may have found a job or a food pantry to help.
The ACO experiment is off track, turning physicians into social workers. We should deploy more resources to help people with these needs, but we should not deploy some of the most expensive workers in the world to do so.
Another example, the "Oncology Care Model," operated at a net loss of $639 million for Medicare, but cancer patients indicated that the program didn't improve their treatment experience. After several years of running the pilot, CMMI reformed the model and made it worse -- fewer doctors and patients ended up participating.
Incredibly, CMMI imposes many of these sweeping, billion-dollar changes to Medicare and Medicaid without public input. And CMMI can permanently change the program because Congress gave bureaucrats the power to impose these models on all Medicare beneficiaries. What a terrible, anti-democratic idea.
No baseball team would keep a player who consistently underperforms, drains resources, and refuses accountability. Keeping CMMI on the government's roster, despite its dismal record, would be like letting a failed slugger eat up payroll while dragging the team down. Time to axe this costly and failed Obamacare experiment.
Joel White is the President of the Council for Affordable Health Coverage, a non-profit advocacy organization that seeks to lower the cost of health care for all Americans.
Editor's Note: The Democrat Party has never been less popular as voters reject its globalist agenda.
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