CBO Director Orszag Calls For Improvements In CMS Demos, More Data From Insurers

Main Category: Health Insurance / Medical Insurance
Article Date: 30 Jan 2008 - 10:00 PDT

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Congressional Budget Office Director Peter Orszag on Monday said that CMS demonstration projects lack "the key elements that you would expect in a rigorously designed evaluation" to determine whether the projects are saving money and improving health care quality, CongressDaily reports. Orszag said that the demonstration projects are not set up in ways that other agencies can "learn the things that we need to learn in order to score future proposals."

Orszag said he is "continuing to beg" for data from insurance companies about Medicare Advantage plans. "It's almost like they're conducting a variety of experiments in disease management and various other things. And they are doing so with public subsidies." He added, "In exchange for this publicly funded set of experiments, we should be getting a set of rigorous data back on what works and what doesn't, and that is, unfortunately, not as complete and as rigorous as one would hope." Orszag noted that private fee-for-service MA plans have a "very light reporting requirement," which makes it difficult to measure success.

Orszag said that CBO has been working with America's Health Insurance Plans to get information from insurers about whether their disease management programs have been effective, adding, "We continue to interact constructively and I would say I'm still waiting for rigorous data. ... I think there is a willingness to provide it, but it does take time" because of insurance association privacy regulations and other constraints.

AHIP spokesperson Mohit Ghose said that insurers and the government have a shared goal of continuing to "demonstrate the value our member plans bring to Medicare," adding, "The issue is, how best to provide the most relevant data" (Johnson, CongressDaily, 1/29).

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