Blue Cross Blue Shield alternative quality contract cuts costs, improves care

Blue Cross Blue Shield of Massachusetts (BCBSMA) has cut costs and improved quality care with its alternative quality contract program, according to a new study published in the journal Health Affairs.

The 4,800 doctors working with the BCBSMA alternative quality contract spent 3.3 percent less in 2010 (the second year of the program), compared to non-participating doctors, amounting to a $107 savings per patient. Some doctors spent almost 10 percent less than their counterparts operating under fee-for-service contracts, reported The Boston Globe.

What's more, the participating doctors scored higher on certain quality care measures, including chronic care management, pediatric care, cancer screening and other preventive care, WBUR reported.

Doctors primarily saved "in a really smart way" by switching to lower-cost options for scans and imaging but generally didn't alter patients' existing relationships with specialists and hospitals, regardless of whether they were high-priced options, Dana Gelb Safran, a senior vice president at Blue Cross and a professor at Tufts University School of Medicine who worked on the study, told the Globe.

"If these results and improvements continue, the healthcare system can be put on a sustainable path," senior study author Michael Chernew said. However, he cautioned that the findings regarding quality of care improvements may be inconclusive because "quality measurement is an evolving field." For example, the study didn't determine whether providers decreased the number of imaging tests by reducing wasteful imaging or cutting procedures that could have improved care, Kaiser Health News reported.

A study of BCBSMA's alternative quality contract in the first year showed more modest results; participating doctors spent 1.9 percent less than doctors, averaging $62 per-patient savings.

To learn more:
- read the Health Affairs study
- read the Boston Globe article
- check out the Kaiser Health News article
- see the WBUR article