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January 22, 2008

Umm, did somebody say "capitation"?

Check it out, straight from the Boston Globe:

Blue Cross and Blue Shield of Massachusetts wants to stop paying doctors and hospitals for each patient visit or treatment, a common arrangement that most experts agree has led to unnecessary, inefficient, and fragmented care that is sometimes harmful to patients.

Instead, they want to pay doctors and hospitals a flat sum per patient each year, adjusted for age and sickness, plus a significant bonus if the providers improve care, Blue Cross officials said. In most cases, the payment would cover all services from primary care doctors, specialists, counselors, and hospitals - forcing them to work together closely.

While driving to a meeting this morning, I heard Paul Levy, of BIDMC and Running a Hospital fame, and Andrew Dreyfus of BCBSMA, chatting about this new optional contract on the radio.  Have a listen, and check out today's post at CommonHealth, too.

Let's hope the variations on the theme this time around entice some providers to opt in -- the more data, on the more variations, the merrier.

Update 1/23/08:  The variations this time around include, as Andrew noted in a follow-up comment to yesterday's post at Commonhealth, fixed payments (which conjure up organized medicine's rationing bogeyman), coupled with incentive payments based on quality measures (which should help put it to rest).

-- David Harlow


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