Nearly a decade ago, Dr. Jeffrey Brenner and his Camden Coalition appeared to have an answer to remake American health care: Treat the sickest and most expensive patients. But a rigorous study in the New England Journal of Medicine shows the approach doesn’t save money. “We built a brilliant intervention to navigate people to nowhere,” Brenner tells the “Tradeoffs” podcast.

The proportion of money that California hospitals spent on free and discounted care for low-income people dropped by more than half from 2013 to 2017 — even for nonprofit hospitals. Hospitals say there’s less demand for charity care because more people now have health insurance, but consumer advocates counter that people still need help.