Findings Support ACO Model of Care

Driving value-based care delivery through incentives that reward lower-cost measures showed promising results in a recent study. It found that using a commercial health insurer's large scale health plan, designed to improve quality and lower costs for private subscribers, also lowered costs for Medicare patients.

Harvard University researchers Dr J. Michael McWilliams, Dr Bruce Landon, and Dr Michael Chernew analyzed 11 health systems that used Blue Cross Blue Shield of Massachusetts' alternative quality contracts (AQCs). Under these ACQs, certain quality measures are used to drive lower-cost spending when caring for Medicare beneficiaries. The contracts resulted in improved quality, while spending fell 1.9% in the first year and 3.3% in the second year.

"These findings suggest that provider groups are willing—and able—to make systemic changes that result in higher-value care for patients across the board," said Dr McWilliams, "Additional efforts such as recent state initiatives to contain spending may be needed to foster multipayer participation in new payment systems. Our study of an early ACO program in Massachusetts suggests the potential for these payment models to drive systemic changes in care delivery."

These alternative contracts could provide evidence as to how accountable care organizations might operate using incentive-based contracts. They also demonstrate that while providers have made changes to reduce spending, they can do much more in quality improvement strategies.

“Annual rates of low-density lipoprotein cholesterol testing differentially improved for beneficiaries with diabetes in the intervention group by 3.1 percentage points and for those with cardiovascular disease by 2.5 percentage points, but performance on other quality measures did not differentially change,” the authors wrote.

Widespread savings could encourage additional hospitals and medical groups to more openly enter into incentive-based contracts that would improve their standards in quality of care.

Around the Web

Private-payer ACOs Good for Medicare, Study Says [Modern Healthcare]

Lower Costs from Commercial Alternative Quality Contract Spill Over to Patients Not Covered by the Plan [Medical Xpress]

Mass. Study: Savings ‘Spillover’ From Blue Cross Global Plan [Common Health]