Nine hospitals may exit the CMS Pioneer pilot project to manage the care of patients with chronic conditions under a capitation model instead of fee-for-service. Though health systems in the program had some experience coordinating care, they might not have the clinical control over patient behavior they were expecting, says Robert Blendon of Harvard University's School of Public Health. "It really shows a critical cost-containment approach in the Affordable Care Act is running into real problems," Blendon said.

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