Medicare payment reforms in the Affordable Care Act might lead to more efficient treatment cycles, but they might not wind up lowering overall payouts to providers and other stakeholders, according to a new analysis.

Researchers, writing in the September issue of the journal Health Affairs, said that demonstration projects featuring accountable care organizations, bundled payments and other strategies might not be enough.

“Experience amply demonstrates that persistent cost containment is not a given,” they wrote.

Post-acute prospective payment system reforms 10 years ago led to less treatment of less profitable patients, poorer outcomes and only a temporary slowdown in overall payouts, study authors observed.

By law, the ACA mandates reductions in pay hikes for providers through fiscal 2019.