Why Clinical Guidelines Matter More With Risk-Based Contracting

Clinical practice patterns in the U.S. have always had great variance. Over the past 35 years, since The Dartmouth Atlas Study, research has documented great geographic variations in health care practices. These variances do not necessarily correlate with quality of care (see Improving Quality and Curbing Health Care Spending: Opportunities for the Congress and the Obama Administration). These issues are magnified for consumers with complex care conditions and chronic conditions—with often unstudied complications of comorbid conditions and unmet social support needs.

This variance, and how actual service delivery varies from clinical guidelines, has always been of concern to . . .