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Contagious savings
Date:8/28/2013

A commercial health insurer's large scale demonstration program designed to improve quality and lower costs for subscribers also lowered costs for Medicare patients who used the same health care providers but were not covered by the plan.

"These findings suggest that provider groups are willingand ableto make systemic changes that result in higher-value care for patients across the board," said author J. Michael McWilliams, assistant professor of health care policy and medicine at Harvard Medical School and a practicing general internist at Brigham and Women's Hospital.

The results are in the August 28 issue of JAMA.

McWilliams, along with Michael Chernew and Bruce Landon, both HMS professors of health care policy, examined whether the Blue Cross Blue Shield of Massachusetts (BCBS) Alternative Quality Contract (AQC), an early commercial accountable care initiative associated with reduced spending and improved quality for BCBS enrollees, was also associated with changes in spending and quality for Medicare beneficiaries who were not covered by the AQC.

The researchers found that, within two years, providers who were part of the AQC achieved significant savings (more than 3 percent) for the Medicare beneficiaries they served relative to a control group served by other providers. Quality metrics for the patients in the intervention group either went up or stayed level, meaning the overall value of care rose.

In an accountable care organization (ACO), health care providers assume some financial risk for the costs and quality of the care they deliver. For example, instead of receiving a set fee for each service delivered , provider organizations might receive an annual global budget to care for their patient population. In a two-sided risk-sharing agreement like the AQC, if spending exceeds the budget, the ACO loses money; if spending falls below the budget, the ACO shares in the savings. ACOs also have financial incentives to meet cer
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Contact: David Cameron
david_cameron@hms.harvard.edu
617-432-0441
Harvard Medical School
Source:Eurekalert

Page: 1 2 3

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