A Healthy Blog

Massachusetts health care — wonky, with a healthy dose of reality

LA Times Looks At Global Payments in MA

LA Times Looks At Global Payments in MA

December 14, 2012

Outsiders can often see you with better perspective than people close to you. At least smart outsiders who know what they're talking about.

That's often the feeling I get when I read coverage of Massachusetts health developments from out-of-state sources.

Today's exhibit is a well done article in the LA Times by Noam Levey. The online headline is "A shift in how healthcare is paid for," with this kicker:

In Massachusetts, thousands of physicians receive more pay if their patients stay healthy and avoid costly medical care. It could become a national template.

The story has good detail and analysis about the shift to global payments already occurring in the market here:

This simple shift in how healthcare is paid for — long seen as key to taming costs — has been occurring in pockets of the country. But nowhere is it happening more systematically than in Massachusetts, the state that blazed a trail in 2006 by guaranteeing its residents health insurance. Now Massachusetts, a model for President Obama's 2010 national healthcare law, may offer another template for national leaders looking to control health spending.

"There have been few greater periods of change in American medical history … and this is the epicenter," said Dr. Kevin Tabb, a former chief medical officer at Stanford Hospital and Clinics in Northern California who now heads Beth Israel Deaconess Medical Center, one of Boston's leading hospitals. "It is striking how different Massachusetts is from the rest of the nation."

In the last three years, commercial insurers in the state have moved nearly 1 million patients into health plans that reward doctors and hospitals that control costs while improving quality.

About 180,000 Massachusetts seniors are on track to get care from physicians paid this way by Medicare through a new initiative included in the national health law. And this summer, state lawmakers passed legislation aimed at moving 1.7 million government employees and Medicaid recipients into similar health plans.

Within a few years, close to half of the state's 6.5 million residents could be in a health plan that pays for medical care in a fundamentally different way.

The article discusses the experience of the Blue Cross "Alternative Quality Contract," and looks at the experience through the eyes of physicians and patients. All in all, this is as good a summary of where things are today as we've seen.
 -Brian Rosman