Blue Cross Blue Shield of Massachusetts' Alternative Quality Contract Offers New Contracting Design

NASHVILLE, Tenn., Nov. 4 /PRNewswire/ -- HealthLeaders-InterStudy, a leading provider of managed care market intelligence, reports that Blue Cross Blue Shield of Massachusetts is making a significant change from its traditional fee-for-service contracts with its Alternative Quality Contract. Begun in 2008, the Alternative Quality Contract is intended to combine the best features of capitation and pay-for-performance. The voluntary option includes two forms of payments: a fixed payment per patient, per year, adjusted for the health of the patient, and performance incentives tied to nationally accepted measures of quality, effectiveness and improvement of care.

According to the recent Springfield Market Overview, Hampden County Physician Associates was one of the first providers in Massachusetts to sign a five-year Alternative Quality Contract with Blue Cross Blue Shield of Massachusetts. The five-year contract includes an annual payment adjusted for inflation and for sicker patients, and bonuses based on quality-of-care performance. Hampden County Physician Associates also is working on becoming accredited as a medical home.

"As of July, more than 2,000 physicians were included in the Alternative Quality Contract, demonstrating the increasing uptake of these performance-based initiatives," said Deborah White, market analyst with HealthLeaders-InterStudy. "While discussions around national healthcare reform have a lot of people looking at what's happening in Massachusetts, the outcomes of this Alternative Quality Contract will be closely watched."

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    Lisa Osgood                        Elizabeth Marshall
    HealthLeaders-InterStudy           Decision Resources, Inc.
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