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Tying Payment to Value: Lessons Learned from the Blue Cross Blue Shield of Massachusetts Alternative Quality Contract

Summary

By the end of 2016, HHS plans to make 30% of fee-for-service payments through alternative payment models, such as accountable care organizations and bundled payments, and tie 85% of all fee-for-service payments to quality or value. This places increasing urgency on healthcare organizations to make a fundamental shift in their approach to care delivery.

Existing value-based care models, such as Blue Cross Blue Shield of Massachusetts’ Alternative Quality Contract (AQC), can offer valuable guidance. Launched in 2009, the AQC offers two-sided risk for the total cost of patient care plus significant earning potential based on quality and outcomes measures. Nearly 90% of BCBSMA’s network providers participate in the program today, and studies show that it has slowed spending growth and improved quality.

During this webinar, we:

  • Explore key lessons learned from the AQC, drawing on insights from former federal government executives, payer leaders, and providers.
  • Discuss the implications of early AQC experience for national payment reform efforts.
  • Uncover opportunities and challenges for multi-payer models built around existing programs.

Other panelists include: Mark McClellan, Senior Fellow and Director, The Brookings Institution; Bob Kocher, Partner, Venrock; Dana Safran, Senior Vice President, Blue Cross Blue Shield of Massachusetts

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