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From Our Sponsor | Transforming the Health Payment System

August 1, 2019
The state’s largest not-for-profit insurer, Blue Cross Blue Shield of Massachusetts, is quietly transforming the health payment system, improving care while constraining costs, a landmark new study finds. 
The Boston Globe reports that Blue Cross’ innovative Alternative Quality Contract slowed the rate of health care spending growth by nearly 12% while improving patient care from 2009-2017. The report is based on a Harvard Medical School study published in the New England Journal of Medicine.
"This independent and rigorous evaluation of eight years of data demonstrates that the AQC is achieving its twin goals of lower costs and better care for our members," said Blue Cross Blue Shield of Massachusetts President and CEO Andrew Dreyfus.
"These impressive results would not have been possible without the incredible effort, commitment and leadership of our physician and hospital partners."
The average claims by patients with doctors in the AQC were $461 less than those of the control group, an average claims savings of 11.7% per patient. Savings accelerated over time, the study found.
The study also found that the AQC improved the quality of care and the quality of health for members across several measures compared to New England and national averages. For example, the study found an increase in the rate of members with cardiovascular conditions who are managing their cholesterol and blood pressure. 
Blue Cross Blue Shield of Massachusetts introduced the AQC in 2009 as an alternative to the traditional fee-for-service payment model. The model combines a global budget for a patient population with significant performance incentives based on nationally accepted quality metrics.
Physicians and hospitals that adopt the AQC agree to take responsibility for the full continuum of care
received by their patients, regardless of where the care is provided. Today, more than 80 percent of the physicians and hospitals in the health plan’s network participate in the AQC.
“The continued success of the AQC reflects the commitment of the participating physicians and hospitals to redesign the way they deliver care to emphasize quality and efficiency,” Dreyfus said. “Our partnership provides strong evidence that global budget models like the AQC can lead to significant quality improvements and cost savings."
The not-for-profit health plan serves more than 2.8 million members. Its customers include more than 25,900 business across Massachusetts and nearly 80 percent of Massachusetts cities and towns.
Read the full Globe report here
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