The Congressional Budget Office has some disappointing news: Two decades worth of experiments to bring down Medicare costs have not worked very well. The agency published results today from 10 Medicare demonstrations that have piloted new ways to coordinate care and tie provider payment to quality.

So how did they work?

“CBO finds that most programs tested in those demonstrations have not reduced federal spending on Medicare.”

Why didn’t the demonstrations reduce costs? Largely because they didn’t reduce the quantity of care delivered. Some programs actually correlated with increased hospital admissions. A few saw reductions. On balance, it was pretty much a wash — and a troublesome sign for the health reform law’s soon-to-launch attempts to curb Medicare spending.