Partners HealthCare to join Massachusetts Blue's global payment program
Partners HealthCare, a nine-hospital health system with 1,300 primary care physicians and more than 6,000 specialists has agreed to join Blue Cross Blue Shield of Massachusetts' Alternative Quality Contract (AQC) global payment model beginning Jan. 1, 2012.
The AQC, launched in 2009, is a shared savings, shared risk payment model that pays providers a fixed per-patient payment combined with significant payment incentives tied to the so-called "triple aim" of improving the quality, effectiveness and patient experience of the care they receive.
"By joining the Alternative Quality Contract, Partners has committed to work with us in a deeper, more collaborative way to lower the cost and improve the quality of the care they deliver to our members," said Andrew Dreyfus, BCBSMA's president and CEO in a press release.
Partners HealthCare is the largest provider yet to participate in the AQC and the new three-year contract with the insurer will cover more than 200,000 BCBSMA members. In all, the two organizations anticipate total health costs savings of roughly $80 million in 2012 and more than $240 million over the life of the contract.
The announcement comes as Partners is in the beginning stages of what it calls "A Case for Change," an internal program that aims to save more than $300 million – or about 5 percent – in total costs over the next three years. Announced in early September, the program will look to find its savings by eliminating inefficiencies in overhead and direct patient expenses and by redesigning its care programs for several high-cost conditions including colon cancer, diabetes, stroke and coronary disease (heart attack and bypass surgery).
"Our goal is to manage utilization and costs and create savings for our patients," said Gary Gottlieb, Partners president and CEO at the time of the announcment.
But Partners participation in the three-year-old AQC will look to ramp up the savings even further from the earlier iterations of the payment model, by participating in what BCBSMA is calling AQC 2.0. Under this model, Partners will need to outperform the rest of the providers in BCBSMA's network with the possibility of needing to pay money back to the insurer if they don't reach their care and quality goals.
"Our customers and members will be the beneficiaries of these savings," Dreyfus added. "We've been clear for some time now that making quality healthcare affordable is our highest priority as an organization. This new agreement with Partners is an important step forward."
The AQC has proven to be an effective model for reducing medical spending. A July 2011 article published in the New England Journal of Medicine showed that the program was slowing cost growth, with spending 2 percent lower for AQC providers than their peers in the traditional fee-for-service model and even greater – 6 percent – for providers new to a global payment model.
