BCBSMA global payment model reduces spending, improves quality of patient care

A just-released study by a team of researchers at the Harvard Medical School finds that a new global payment model being implemented by Blue Cross Blue Shield of Massachusetts (BCBSMA) is meeting its twin goals of slowing the growth in health care costs while simultaneously improving the quality of patient care.

The comprehensive study is the first independent review of BCBSMA's Alternative Quality Contract (AQC) which was introduced in 2009. The study, published in the New England Journal of Medicine, analyzed 2006-2009 claims data for members whose primary care physicians were in the AQC, compared with members not in the AQC. The Harvard Medical School press release summarizing the study's findings can be found below.

Reacting to the findings, BCBSMA CEO Andrew Dreyfus said "we're pleased that this independent and rigorous analysis of the first year of our new payment model finds that the AQC is playing a key role in helping these physicians and hospitals redesign the way they deliver care to emphasize value over volume." Dreyfus added the study offers important insights and lessons for state and federal policymakers considering reforms to the health care payment system.

In the study, researchers found three key lessons including:

1) Quality does not need to be threatened by global payment.
2) Global payment can introduce greater price competition into the market as referrals move from high-price to low-price facilities.
3) Setting appropriate budgets and providers' ability to practice in this new environment are essential to continued success.