Healthcare economies of scale

Only 1 of 10 cost-control efforts attempted by Medicare over two decades has saved the government money, the Congressional Budget Office (CBO) reported in January. Richard Gilfillan, head of the most ambitious attempt yet, says he can get over that very low bar. Gilfillan runs the $10 billion Center for Medicare and Medicaid Innovation created by the 2010 U.S. healthcare law to identify ways to lower medical costs and improve the quality of care. His solution, now taking shape, is to transfer the job from bureaucrats to companies and private individuals competing in a changing marketplace. Gilfillan wants the ideas to bubble up from the private sector—and they have, in multitudes.