BlueCross BlueShield of Massachusetts Draws from FMA Methodology to Develop New Payment Method

Rochester, NY – January 21, 2011 -- In 2009, Blue Cross Blue Shield of Massachusetts initiated an innovative new payment system called the Alternative Quality Contract. Within the system, which is an alternative to traditional fee-for-service models, participating medical groups receive global payments plus incentives based on savings generated and performance targets met.

The participating medical groups receive reports which provide ongoing feedback concerning their performance relative to the quality bonus measures and their established budgets. The reports emphasize unexplained variations in practice patterns which, in this system, are clinically and financially important to the participating medical groups.

Blue Cross Blue Shield of Massachusetts, an FMA client, drew from FMA's methodology in creating the reports. This, along with program details and a summary of the encouraging first year results, was published in the January 2011 issue of Health Affairs.

Click her for Health Affiars Abstract