To the Editor: In understanding the study of the effects of care coordination on hospitalization, quality of care, and health care expenditures among Medicare beneficiaries by Dr Peikes and colleagues,1 it is important to examine the purpose of demonstration programs during the evaluation process. These practical studies are performed to determine which programs work and which do not. Medicare should examine and learn from the failures and even more closely evaluate the successes of the demonstration programs to determine which practices could—and should—be implemented among larger populations. From the demonstration programs described in this study, the medical community learned that the programs with the greatest focus on care coordination reduced costs and patient hospital stays. It indicated that directing efforts toward most-affected populations and establishing healthy lifestyles early in life may be critical to improving the quality of health and the health care system.
Carmona RH. Evaluating Care Coordination Among Medicare Beneficiaries. JAMA. 2009;301(24):2547-2548. doi:10.1001/jama.2009.873