Professor Chernew and his co-authors (two of them are employees of Blue Cross) have done their best to spin their findings to the advantage of the insurance company. The most egregious example of this is their decision to define "total medical spending" one way for ACO enrollees and another way for the fee-for-service population. As a result, all payments from Blue Cross to the fee-for-service providers are included, while for the ACO population, the actual capitation payment -- as well as the pay-for-performance payments that are part of this model -- are simply omitted. Sound bizarre? If you have difficulty believing that Harvard researchers could place their names on such fundamentally (not to say cynically) flawed work, I encourage you to read it yourself.
Now of course any reasonable (but otherwise uninformed) reader of the above article will come away with a reassuring feeling of confidence that the good people at Blue Cross had successfully controlled costs to some extent with this new payment model. Which is terribly unfortunate; since in reality, in the two-year period studied, this payment scheme significantly increased costs. Why? In part because, for the experimental group, doctors were paid more and operating budgets were increased. What a novel way of saving money!
So why would Blue Cross recruit Harvard faculty to publish this sort of double-speak? The answer is just as straightforward as the study is flawed: because doing so serves their financial interests. The current popularity of global payment schemes (and gushing over "affordable care organizations") is, transparently, part of the insurance industry's latest disinformation campaign. And this industry will continue to blow smoke in the eyes of the commonwealth until it is finally replaced by the simple (frugal, structurally just, and sustainable) solution utilized to varying degrees by 100% of the rest of the developed world: single payer.