Such a move could potentially compromise safety and mean a lower quality of care".
"States that spend more per capita often have a lower quality of care," said Karen Davis, a health economist who is president of the Commonwealth Fund.
Worried that financial pressures might lead to lower quality of care, the Medicare commission also examined how hospitals that did a good job of controlling costs compared on measures like mortality rates and readmissions.
Measuring one component of health care delivery and forcing changes based on that measurement, while neglecting other important but harder-to-measure variables, may worsen efficiencies and lower quality of care.
"Racial differences in outcomes were not related to black patients differentially receiving care from physicians who provide a lower quality of care, but rather that black patients experienced less ideal or even adequate outcomes than white patients within the same physician panel," the study concluded.
"Such arrangements have the potential to generate cost savings and quality benefits for patients," said Richard A. Feinstein, director of the Bureau of Competition at the F.T.C. "However, in some cases, the arrangements can create highly concentrated markets that may harm consumers through higher prices or lower quality of care".
In a joint statement on enforcement policy, the two agencies acknowledged that, "under certain conditions, accountable care organizations could reduce competition and harm consumers through higher prices or lower quality of care" — a fear expressed by some consumer advocates as well.
Prior research has produced conflicting results about whether for-profit health plans provide lower quality of care.
Data indicate that black women receive care in a concentrated set of hospitals and that these hospitals appear to provide lower quality of care.
Therefore, individuals who are most at risk of incarceration are already more likely to have lower levels of self-rated health, less access to medical care and health insurance, and lower quality of care (Veenstra 2011).
