And the same cold water could end up being splashed on the equally good ideas behind the various pilots and demos in the recently passed Patient Protection and Affordable Care Act (APPAC). In Section 3021 (p. 271), the yet to be formed Center for Medicare and Medicad Innovation is charged with testing various models of care including medical homes. The HHS Secretary may, 'through rulemaking,' expand the models if:
"...the Chief Actuary of the Centers for Medicare & Medicaid Services certifies that such expansion would reduce program spending under applicable titles."
The policy response from the White House and its Favored Chosen, of course, is spin. Given the Chief Actuary's uncanny similarity to the DMCB spouse, however, the DMCB isn't sure that spin will meet "reduce program spending" muster.
In the meantime, the DMCB is moving on. Inspired by the release of the movie Avatar on DVD, its latest pilot ornament idea is to festoon our shrubbery with solar powered glo-in-the dark Pandora-like butterflies. The DMCB looks forward to the DMCB spouse's analysis and the expansion of this meritorious landscaping model.