Reform Model Lowers Costs, Improves Care

[Greenbeard]

Some interesting results were announced today from a private sector payment reform experiment whose approach is being replicated around the country under the Affordable Care Act.

Study: Mass. Global Payment Approach Lowers Costs, Improves Care

The Alternative Quality Contract, a global payment model put in place by Blue Cross Blue Shield of Massachusetts in 2009, has both curbed costs and improved the quality of care, according to a Harvard Medical School study published today in the journal Health Affairs.

Global payments, a lump sum to cover all the care of a defined group of patients, are viewed by many experts as a cost-effective alternative to the traditional fee-for-service system.

Massachusetts enacted sweeping state health reforms in 2006 considered by many to be a prototype of the 2010 federal health law, and it is now experimenting with equally dramatic measures to rein in health care spending. The AQC is very similar to the Affordable Care Act’s Pioneer Accountable Care Organization contracts – a part of the Medicare shared-savings program.

In the state version, 11 health care provider groups were given a fixed budget to care for patients covered by BCBSMA insurance. If the providers stayed under budget, they were given bonuses. If they went over, they had to eat those costs.

After studying data from Blue Cross Blue Shield’s claims and comparing them to claims from doctors not participating in the AQC, the researchers found that – during the second year – providers participating in the global payment system spent an average of 3.3 percent less than the other groups. Those providers who came from traditional fee-for-service contract models achieved the greatest savings – as much as 9.9 percent in year two.

The study also found the participating provider groups achieved quality improvements in chronic care management, pediatric care and adult preventive care, especially in year two.

Encouraging news.

For a taste of what this means on a wider scale, here's a flashback from a year ago when Blue Cross Blue Shield of MA was describing the implications of the Year One results of the Alternative Quality Contract (AQC):

The provider organizations participating in the AQC exemplify the concept of Accountable Care Organizations (ACO) and Patient Centered Medical Homes (PCMH) as envisioned by the Patient Protection and Affordable Care Act of 2010 (PPACA) and the recommendations of Massachusetts’ Special Commission on Health Care Payment System in 2009. [...]

The PPACA promotes the experimentation of delivery system and payment reforms, such as ACOs and PCMHs, through Medicare demonstrations and payment reform policies, Medicaid program options for states, as well as the Center for Innovation at the Centers for Medicare and Medicaid Services (CMS). [...]

For federal and state policymakers, the findings from the first year of the AQC hold several important lessons. Among these is evidence that improvements in both health care quality and spending are achievable through a payment model that establishes provider accountability for quality, outcomes and costs.

Now I suppose we can add to that lesson that it just keeps getting better in year two.

 

[Quantum Windbag]

Let me see if I understand what this paper is saying, The escalating costs of health care in Massachusetts are directly not related to any of the reforms instituted by Romneycare, they are all just a plot by subversive elements that want to destroy Obama.

 

[zonly1]

Some interesting results were announced today from a private sector payment reform experiment whose approach is being replicated around the country under the Affordable Care Act.

Study: Mass. Global Payment Approach Lowers Costs, Improves Care

The Alternative Quality Contract, a global payment model put in place by Blue Cross Blue Shield of Massachusetts in 2009, has both curbed costs and improved the quality of care, according to a Harvard Medical School study published today in the journal Health Affairs.

Global payments, a lump sum to cover all the care of a defined group of patients, are viewed by many experts as a cost-effective alternative to the traditional fee-for-service system.

Massachusetts enacted sweeping state health reforms in 2006 considered by many to be a prototype of the 2010 federal health law, and it is now experimenting with equally dramatic measures to rein in health care spending. The AQC is very similar to the Affordable Care Act’s Pioneer Accountable Care Organization contracts – a part of the Medicare shared-savings program.

In the state version, 11 health care provider groups were given a fixed budget to care for patients covered by BCBSMA insurance. If the providers stayed under budget, they were given bonuses. If they went over, they had to eat those costs.

After studying data from Blue Cross Blue Shield’s claims and comparing them to claims from doctors not participating in the AQC, the researchers found that – during the second year – providers participating in the global payment system spent an average of 3.3 percent less than the other groups. Those providers who came from traditional fee-for-service contract models achieved the greatest savings – as much as 9.9 percent in year two.

The study also found the participating provider groups achieved quality improvements in chronic care management, pediatric care and adult preventive care, especially in year two.

Encouraging news.

For a taste of what this means on a wider scale, here's a flashback from a year ago when Blue Cross Blue Shield of MA was describing the implications of the Year One results of the Alternative Quality Contract (AQC):

The provider organizations participating in the AQC exemplify the concept of Accountable Care Organizations (ACO) and Patient Centered Medical Homes (PCMH) as envisioned by the Patient Protection and Affordable Care Act of 2010 (PPACA) and the recommendations of Massachusetts’ Special Commission on Health Care Payment System in 2009. [...]

The PPACA promotes the experimentation of delivery system and payment reforms, such as ACOs and PCMHs, through Medicare demonstrations and payment reform policies, Medicaid program options for states, as well as the Center for Innovation at the Centers for Medicare and Medicaid Services (CMS). [...]

For federal and state policymakers, the findings from the first year of the AQC hold several important lessons. Among these is evidence that improvements in both health care quality and spending are achievable through a payment model that establishes provider accountability for quality, outcomes and costs.

Now I suppose we can add to that lesson that it just keeps getting better in year two.

How is healthcare all of sudden the low cost producer....you have evidence from tabloids crap? How about some acutual pilot studies....? No
U go to medicare as the reference point of bench march to make your ludacris points ,,,,barry ...it's just words.

Why are you so quilable to allow the gubbermint to handle your monies as if they have done such a great job already...the number of bankrupt cities in California...means lawlessness......6-25-2012 obumer declares a state of emergency further inacting NDAA as he signed out the side of his mouth.

 

[Greenbeard]

Let me see if I understand what this paper is saying, The escalating costs of health care in Massachusetts are directly not related to any of the reforms instituted by Romneycare, they are all just a plot by subversive elements that want to destroy Obama.

Romneycare's weakness is that, unlike the ACA, it was solely a coverage expansion. It paid no attention to cost control and quality improvement (e.g. through payment reform); the state has only turned its attention to that now and its payment reform legislation is currently in conference.

What BCBS of MA did on its own a few years ago is push forward with the kind of cost control/quality improvement oriented payment reform ideas that the ACA's writers had in mind. They're pioneering it and the first few years of the experiment have been very promising.

How about some acutual pilot studies....?

Yes. See above.

 

[Greenbeard]

Meanwhile, the spread of this model as part of the ACA's Medicare reforms has thus far exceeded expectations:

The number of accountable care organizations (ACOs) in Medicare is growing faster than industry leaders had predicted when the program's rules were finalized last fall. As of July 1, 89 new ACOs had begun serving 1.2 million people, bringing to 154 the number of groups in the Medicare shared-savings effort in 40 states and Washington, D.C.

The 2.4 million Medicare beneficiaries participating in ACOs is still a minority in the 46-million-patient Medicare program. But as Centers for Medicare and Medicaid Services (CMS) principal deputy administrator and Center for Medicare director Jonathan Blum noted in a call with reporters, when the regulations for the program were first proposed, "there were many doubts about whether ACOs would come into the program."

All Medicare ACOs that cut the rate of spending growth in the cost of care without compromising the quality of care may share in the Medicare savings. ACOs will have to demonstrate high-quality care by reporting 33 different performance measures.

 

[onecut39]

Some interesting results were announced today from a private sector payment reform experiment whose approach is being replicated around the country under the Affordable Care Act.

Study: Mass. Global Payment Approach Lowers Costs, Improves Care

The Alternative Quality Contract, a global payment model put in place by Blue Cross Blue Shield of Massachusetts in 2009, has both curbed costs and improved the quality of care, according to a Harvard Medical School study published today in the journal Health Affairs.

Global payments, a lump sum to cover all the care of a defined group of patients, are viewed by many experts as a cost-effective alternative to the traditional fee-for-service system.

Massachusetts enacted sweeping state health reforms in 2006 considered by many to be a prototype of the 2010 federal health law, and it is now experimenting with equally dramatic measures to rein in health care spending. The AQC is very similar to the Affordable Care Act’s Pioneer Accountable Care Organization contracts – a part of the Medicare shared-savings program.

In the state version, 11 health care provider groups were given a fixed budget to care for patients covered by BCBSMA insurance. If the providers stayed under budget, they were given bonuses. If they went over, they had to eat those costs.

After studying data from Blue Cross Blue Shield’s claims and comparing them to claims from doctors not participating in the AQC, the researchers found that – during the second year – providers participating in the global payment system spent an average of 3.3 percent less than the other groups. Those providers who came from traditional fee-for-service contract models achieved the greatest savings – as much as 9.9 percent in year two.

The study also found the participating provider groups achieved quality improvements in chronic care management, pediatric care and adult preventive care, especially in year two.

Encouraging news.

For a taste of what this means on a wider scale, here's a flashback from a year ago when Blue Cross Blue Shield of MA was describing the implications of the Year One results of the Alternative Quality Contract (AQC):

The provider organizations participating in the AQC exemplify the concept of Accountable Care Organizations (ACO) and Patient Centered Medical Homes (PCMH) as envisioned by the Patient Protection and Affordable Care Act of 2010 (PPACA) and the recommendations of Massachusetts’ Special Commission on Health Care Payment System in 2009. [...]

The PPACA promotes the experimentation of delivery system and payment reforms, such as ACOs and PCMHs, through Medicare demonstrations and payment reform policies, Medicaid program options for states, as well as the Center for Innovation at the Centers for Medicare and Medicaid Services (CMS). [...]

For federal and state policymakers, the findings from the first year of the AQC hold several important lessons. Among these is evidence that improvements in both health care quality and spending are achievable through a payment model that establishes provider accountability for quality, outcomes and costs.

Now I suppose we can add to that lesson that it just keeps getting better in year two.

How is healthcare all of sudden the low cost producer....you have evidence from tabloids crap? How about some acutual pilot studies....? No
U go to medicare as the reference point of bench march to make your ludacris points ,,,,barry ...it's just words.

Why are you so quilable to allow the gubbermint to handle your monies as if they have done such a great job already...the number of bankrupt cities in California...means lawlessness......6-25-2012 obumer declares a state of emergency further inacting NDAA as he signed out the side of his mouth.

And your rebuttal is just..................words. Less informed words of course.

 

[onecut39]

Let me see if I understand what this paper is saying, The escalating costs of health care in Massachusetts are directly not related to any of the reforms instituted by Romneycare, they are all just a plot by subversive elements that want to destroy Obama.

The "escalating costs" under Romneycare seem to be escalating a lot slower than those in other states.

 

[EdwardBaiamonte]

Let me see if I understand what this paper is saying, The escalating costs of health care in Massachusetts are directly not related to any of the reforms instituted by Romneycare, they are all just a plot by subversive elements that want to destroy Obama.

The "escalating costs" under Romneycare seem to be escalating a lot slower than those in other states.

More importantly, under a Republican capitalist system people would be spending their own money so the incentive to hold costs down would be increased 1000%. The estimate is that the true cost of health care is only 1/3 of the current liberal cost.

Lets not forget that costs for everything were so high in the USSR only because the government was so liberally involved in the economy.

 

[ConzHateUSA]

Let me see if I understand what this paper is saying, The escalating costs of health care in Massachusetts are directly not related to any of the reforms instituted by Romneycare, they are all just a plot by subversive elements that want to destroy Obama.

The "escalating costs" under Romneycare seem to be escalating a lot slower than those in other states.

More importantly, under a Republican capitalist system people would be spending their own money so the incentive to hold costs down would be increased 1000%. The estimate is that the true cost of health care is only 1/3 of the current liberal cost.

Lets not forget that cost were so high in the USSR only because the government was so liberally involved in the economy.

idiot post