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Harvard Study Finds Success in Alternative Quality Contract (AQC)

A recent study by a team of researchers at Harvard Medical School finds that Blue Cross Blue Shield of Massachusetts' new global payment model, the AQC, is meeting its twin goals of slowing the growth in health care costs while at the same time improving patient care quality.

This comprehensive study is the first independent review of our AQC. Published in the New England Journal of Medicine, it analyzed 2006-2009 claims data for members whose primary care providers (PCPs) were in the AQC, compared with members whose PCPs were not in the AQC.

The Harvard study highlighted the following results:

  • Overall, AQC groups reduced medical spending growth by about 2% in year one of the contract, and groups that did not previously have global budget contracts with Blue Cross Blue Shield of Massachusetts achieved even greater reductions on medical spending (6%).

  • Quality improvements achieved by AQC groups between 2008 and 2009 were significantly greater than those achieved by groups outside of the AQC—with particularly noteworthy improvements achieved for chronic care and pediatric care.

  • Year-one medical savings were achieved largely through AQC changes in referral patterns, most notably for services such as lab, imaging, and routine outpatient procedures.

Reacting to the findings, Blue Cross Blue Shield of Massachusetts' President and CEO, Andrew Dreyfus, said, "We're pleased that this independent and rigorous analysis of the first year of our new payment model finds that the AQC is playing a key role in helping these physicians and hospitals redesign the way they deliver care to emphasize value over volume." Dreyfus added that the study offers important insights and lessons for state and federal policymakers considering reforms to the health care payment system.

"The finding of reduced spending, together with improved quality in year-one of the contract is significant," says senior author Dr. Michael Chernew, Harvard Medical School. "For policymakers contemplating improved payment models for U.S. health care, reducing medical spending while improving quality and outcomes is the Holy Grail. While much remains to be seen over the next years of these AQC contracts and as the model expands to other providers, these early results provide reason for optimism."

Funded by the well-respected Commonwealth Fund, this study was initiated by Blue Cross Blue Shield of Massachusetts.

Read the full study from Harvard Medical.

As of July 31, 2011, Blue Cross Blue Shield of Massachusetts' total AQC membership participation is 441,000, with total AQC provider participation at 2,300 PCPs and 5,100 specialists.

If you have any questions, please contact your account executive.

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