Who can keep track?

Who can keep track?Medicare has launched demonstration projects to improve chronic care for people with multiple conditions. There's plenty to write about that, but here's one tidbit I found interesting in a Wall St. Journal article on the topic:

[P]atients with five or more chronic conditions account for 23% of [Medicare's] beneficiaries but 68% of its spending, seeing an average of 13 different doctors and filling 50 prescriptions a year.

I wonder if the number of physicians is exaggerated but I don't know how anyone could possibly manage to keep track of everything, especially sick people. I guess they don't and that's one reason that Medicare is taking this new approach.On the other hand, the approach is somewhat punitive. The companies running the projects will have to refund some or all of their fees unless costs drop at least 5% and members show improvement and satisfaction. It's great to hold the companies responsible but it doesn't really encourage experimentation.