There's some bad news for those looking for easy ways to trim Medicare spending.
The Congressional Budget Office says two major approaches tested in recent years mostly failed to reduce spending.
Nonpartisan analysts looked at experiments that promoted better care coordination for the chronically ill, trying to keep them out of the hospital. They also studied experiments that changed the way doctors and hospitals get paid, rewarding quality instead of volume.
A report issued Thursday concluded neither approach reduced spending.
Care coordination increased spending in some cases, when added fees for monitoring patients were taken into account.
Payment for value only seemed to save money when providers were given a fixed amount and encouraged to use it efficiently.
Both approaches are part of President Barack Obama's health care overhaul.