There appears to be an interesting alternative.

The Dartmouth Atlas of Care   was released today.  According to the report, it is not the overall chronicity of care that costs american the most during their final two years...it is the intensity of care.  The WSJ healthcare blog reports

Nearly as notable as the Atlas’ findings–that Medicare could have saved as much as $50 billion over five years if all U.S. hospitals cared for dying, chronically ill patients the way the most efficient facilities do– are its proposals for change.

Giving patients a “medical home” by putting one primary doctor or practice in charge of coordinating their care makes sense, particularly for the chronically ill, David Goodman, a Dartmouth pediatrician and Atlas coauthor, told Health Blog. But as long as specialists have an incentive to refer patients to one another ad infinitum, we’re still in for trouble. “An island of medical home is still sitting within these very strong currents of reimbursement incentives that reward inpatient care and intensive care and specialty care,” Goodman said

 Furthermore....

“There is a belief, particularly among patients, that more care is better care,” said John Lumpkin, senior vice-president of the Robert Wood Johnson Foundation, which funds the Atlas. “The Dartmouth Atlas shows that is not the case.”