At Blue Cross Blue Shield of Massachusetts, we work in partnership with hospitals and physician groups across the Commonwealth to advance our shared goal of providing health care that is consistently safe and effective. As part of this commitment, six years ago we began to incorporate incentives for quality and safety measures into our contracts. Leaders of hospitals and large provider groups work with us to identify the precise areas they want to enhance; then we align the incentives with the goals they have chosen.
As a result, our contracts reflect the unique objectives of each institution. Though each contract is different, the goal remains the same: design incentives that advance safe, effective care. We are striving to make sure that everyone, not just our members, receives evidence-based medical care.
The rapid emergence of new radiology and imaging technologies makes it imperative for doctors to have a system that makes it easy to order evidence-based tests. To help providers meet this challenge, we have initiated a network-wide solution.
Beth Israel Deaconess Medical Center (BIDMC) wanted to create a radiology decision-support system that could leverage its advanced electronic health systems. Together, BIDMC, its physician organization, Beth Israel Deaconess Physicians Organization, and Blue Cross Blue Shield of Massachusetts developed a contract that provides incentives for all of us to achieve this ambitious undertaking.
As the result of our collaborative efforts, BIDMC worked with an informatics company to create a new system. Now, when doctors need to order a high-tech imaging study, they use a system that scans the patient's entire medical record — performing an incredible number of safety and cost comparisons in seconds — and enables physicians to identify the most effective test for each and every patient.
The preliminary results are exciting. So far, with an impressive 1,400 physicians using the system, one in 10 high-tech radiology decisions is changed — meaning a safer or more appropriate or more cost effective test was available. And, up to 10 percent of the time, there is a faster and more definitive diagnosis the first time.
Physicians benefit by knowing the most current medical research informs their decisions. Patients benefit by knowing they are receiving the most effective care available. This is but one example of how collaborating with providers helps create a safer, more effective health care system for everyone.