The largest private-sector effort to tame medical spending in Massachusetts appears to be getting results, as doctors who agreed to work on a budget have cut costs by using less-expensive imaging and lab companies and expanding office hours to reduce emergency room use.
Health spending for patients treated through Blue Cross Blue Shield of Massachusetts’ pioneering global-payment program grew more slowly in 2010 than for patients whose physicians were paid the traditional way — receiving a separate fee for every office visit, test, and procedure. At the same time, the 4,800 doctors in the program scored higher on measures of quality of care, according to research published Wednesday.
The study, led by Boston researchers and published online by Health Affairs, bolsters its proponents’ hopes that the approach will play a key role in controlling health spending. President Obama’s health care law establishes a similar budget payment program for Medicare providers, and Massachusetts lawmakers are pushing the same strategy in legislation they plan to finalize this month.
“This is extremely encouraging,” said Paul Ginsburg, president of the Center for Studying Health System Change, a nonprofit research organization in Washington, D.C., that was not involved in the study. “It shows the potential of this whole approach to eventually save on [insurance] premiums.”
In the Blue Cross program — called the alternative quality contract — physicians, and sometimes their affiliated hospitals, accept an annual budget to care for a large group of patients. The amount is adjusted for how healthy the patients are, but is not affected by the number of tests, appointments, and procedures they get. If doctors exceed the budget, they owe Blue Cross money; if doctors come in under budget, they split the proceeds with the insurer.
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