|BCBSMA Signs First Groups To Alternative Quality Contract
Blue Cross Blue Shield of Massachusetts (BCBSMA) has
signed its first provider groups – Mount Auburn Hospital (MAH)
and the affiliated Mount Auburn Cambridge Independent Practice
Association (MACIPA), and Hampden County Physician Associates, LLC
(HCPA) – to its new five-year Alternative Quality Contract (AQC).
First offered in 2008, the AQC pays doctors and
hospitals based on the quality and outcome of the care they provide to
patients. The AQC is designed to improve the quality of care our
members receive and cut current annual medical cost trends in half,
"The announcement reflects the shared vision by BCBSMA
and our physician partners at MACIPA and HCPA of a healthcare system
that delivers safe, effective and affordable care," said Cleve
Killingsworth, BCBSMA’s chairman and CEO. "BCBSMA believes the
most promising way to moderate the increase in the cost of care is to
improve quality. The most effective way to do that is to pay doctors
and hospitals for the quality and outcome of their care."
Also included was BCBSMA’s separate agreement with 45 doctors in Western Massachusetts who are part of HCPA.
The AQC is a significant change from traditional
fee-for-service contracts. It combines two forms of payment. The first
is a global, or fixed, payment per patient adjusted for age, sex, and
health status which increases annually in line with inflation. The
second payment includes substantial performance incentives tied to the
latest nationally accepted measures of quality, effectiveness and
patient experience of care, BCBSMA said.
The contract’s global payment covers all services
received by a patient including primary, specialty and hospital care.
So, when a doctor spends more time with a patient and helps the patient
avoid an unnecessary hospitalization, the patient receives better care,
the doctor and hospital have the potential to receive performance
incentives, and the overall costs are less.
Employers benefit as the new system moderates cost increases through better care.
Address: Blue Cross Blue Shield of Massachusetts, 401 Park Dr., Boston, MA 02115; (617) 246-5000, www.bluecrossma.com.