Challenges to cost-effective care of older adults with multiple chronic conditions: Perspectives of program of all-inclusive care for the elderly medical directors

摘要

To the Editor: In spite of growing interest in achieving cost reduction without compromising quality in the care of clinically complex older adults, little research has been done to evaluate how accountable payment systems operate at the level of the physician. To better understand this, in-depth interviews with 16 medical directors from the Program of All-inclusive Care for the Elderly (PACE), which serves as payer and insurer for nursing home-eligible older adults who wish to maintain residence in community settings were conducted and analyzed.1'2 The goal was to identify challenges and solutions that PACE providers have already faced in their efforts to provide financially accountable health care to high-need Medicare beneficiaries.