The (So Far) Failed Promise Of Electronic Medical Records

Megan McArdle | The Daily Beast | January 21, 2013

Remember how Obamacare was going to "Bend the cost curve" for health care spending?

That was OMB director Peter Orszag, back when Obamacare was being debated.  There were a number of theories about how it would accomplish this.  There were electronic medical records, which had been passed as part of the 2009 stimulus, which would cut down paperwork and medical errors.  And ACOs, which would finally bring America to the promised land of "bundled payments"--i.e., paying a flat fee to keep patients healthy, rather than per-service, which was supposed to radically change treatment incentives.  Medicare pilot projects were going to open up new, more efficient ways to do things.  If all those failed, the legislation contained an Independent Payment Advisory Board which will recommend a panel of automatic cuts unless health care cost inflation stays below a fairly low target level.  

The jury is still out on IPAB, which won't go into effect for a while.  One by one, however, the others have disappointed.  Medicare pilot projects have so far been a near-complete bust; "After accounting for the fees that Medicare paid to the programs . . . Medicare spending was either unchanged or increased in nearly all of the programs", said the CBO.  [...]