"Both challenges and opportunities lie ahead," said Zirui Song, a student at Harvard Medical School and recent graduate of the Harvard PhD Program in Health Policy, and lead author on the study. "With global budgets, provider organizations must divide not only dollars, but authority and autonomy among its member physicians and hospitals. While this transition is likely challenging, it represents a real opportunity to align incentives to coordinate care and keep patients healthy. The AQC teaches us that a successful start is possible, and that supportive payer-provider partnerships are critical."
These findings will be published July 11 in the journal Health Affairs.
In 2009, Blue Cross Blue Shield of Massachusetts launched the Alternalitve Quality Contract. In addition to the global budget, participating groups were also eligible for bonuses if they met certain quality or financial targets. Conversely, groups took on financial risk for any spending over the budget.
Initially seven groups entered the program, followed by four more in 2010. Last year, Song, Chernew and colleagues analyzed data from the program's first year and published the findings in the New England Journal of Medicine.
While the first year analysis also demonstrated reduced spending with increased quality of care, the numbers were even more striking for the second year. Overall savings in year one were 1.9 percent, as opposed to 3.3 percent in year two.
For both years, reduced spending was attributed largely to physicians referring patients to lower-cost facilities. For the second year, lower
|Contact: David Cameron|
Harvard Medical School