Greenbeard
Gold Member
As for those scary "accountable care organizations" (doctors voluntarily working together to take responsibility for their patients' health, care, and safety) that are going to destroy society, early versions of those models are being tried by certain private insurers and their docs around the country.
Here's one in Massachusetts that's lowering costs and improving quality of care for its patients.
The connection to the ACA, mentioned there again:
Holding people accountability for their work can work wonders. But obviously that's a tough transition for folks who aren't used to it.
Here's one in Massachusetts that's lowering costs and improving quality of care for its patients.
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 Acts 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 Shields 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.
The connection to the ACA, mentioned there again:
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.
Holding people accountability for their work can work wonders. But obviously that's a tough transition for folks who aren't used to it.