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Blue Cross Blue Shield of Massachusetts and Atrius Health Sign Alternative Quality Contract

CONTACT: Jenna McPhee
(617) 246-7412
Jenna.McPhee@bcbsma.com

Two leaders in Massachusetts healthcare collaborate to transform delivery of care

BOSTON — July 20, 2009 — Blue Cross Blue Shield of Massachusetts, Inc. (BCBSMA) and Atrius Health announced today that they have signed a new five-year Alternative Quality Contract (AQC). Both organizations have a track record of innovation and this collaboration provides a framework for improving the quality and affordability of care in a patient-centered way.

This contract includes more than 800 physicians affecting more than 106,000 BCBSMA members. Atrius Health has the highest number of physicians of any organization yet to sign the new contract — the contract also doubles the number of BCBSMA HMO members touched by the AQC. With the addition of Atrius Health, the AQC now includes approximately 2300 physicians providing care for more than 210,000 BCBSMA HMO members in total.

Atrius Health is an alliance of five non-profit multi-specialty groups that includes Dedham Medical Associates, Granite Medical, Harvard Vanguard Medical Associates, South Shore Medical Center, and Southboro Medical Group. As the largest independent physician alliance in Massachusetts, Atrius Health medical groups work together to provide an integrated system of care and coordination of treatment for each patient — a structure that directly aligns with the AQC. The AQC aims to reduce fragmentation of care — resulting in better coordination of care for patients and improved patient outcomes.

"The AQC gives physicians the flexibility to change how they manage patient care — dedicating time, resources, and administration to focus on the quality of care provided rather than only the quantity of care," said Cleve Killingsworth, BCBSMA's chairman and chief executive officer. "By signing the AQC, these physicians have demonstrated their commitment to improving the quality, safety, and affordability of the health care services they provide."

"The medical groups in Atrius Health have years of experience with outstanding quality and global payments. We appreciate the vision of BCBSMA to transform Massachusetts healthcare with a comprehensive payment structure that allows our physicians and other medical professional to focus on providing the best care for our patients," said Gene Lindsey, MD, President & CEO of Atrius Health.

The AQC is designed to improve the quality of care BCBSMA's members receive and cut current annual medical cost trends in half. It moderates cost increases through the delivery of better care, resulting in more predictable and affordable premium increases. Opportunities to achieve savings under the AQC include reduction in duplicative services, use of more cost-effective services and providers, and the elimination of potentially preventable costly services, such as certain hospital complications and readmissions.

Since January 2009, the following hospitals and provider groups have agreed to Alternative Quality Contracts: Mount Auburn Hospital and the affiliated Mount Auburn Cambridge Independent Practice Association (MACIPA), Hampden County Physician Associates, LLC (HCPA), Tufts Medical Center and the affiliated New England Quality Care Alliance (NEQCA), Signature Healthcare Corporation including Brockton Hospital, and Lowell General Hospital.

About the Alternative Quality Contract
The AQC is a significant change from traditional fee-for-service contracts. It combines two forms of payment. The first is a global, or fixed, payment per patient adjusted for age, sex, and health status that increases annually in line with inflation. The second payment includes substantial performance incentives tied to the latest nationally accepted measures of quality, effectiveness, and patient experience of care. The contract’s global payment covers all services received by a patient, including primary, specialty, and hospital care. So, when a doctor spends more time with a patient and helps the patient avoid an unnecessary hospitalization, the patient receives better care, the doctor and hospital have the potential to receive performance incentives, and the overall costs are less. Employers benefit as the new system moderates cost increases through better care. You can read more about the AQC by visiting www.bluecrossma.com/quality.

Atrius Health
Atrius Health (www.atriushealth.org) is an alliance of five community-based medical groups including Dedham Medical Associates, Granite Medical, Harvard Vanguard Medical Associates, South Shore Medical Center, and Southboro Medical Group that is committed to making it easy for patients to be healthier. The Massachusetts nonprofit organization was created to enable collaboration on new and better ways of delivering care while maintaining an emphasis on care for the local community. Atrius Health represents more than 800 physicians and over 1,250 other health professionals serving nearly 700,000 patients throughout over 30 sites in eastern Massachusetts.

 

Blue Cross Blue Shield of Massachusetts ( http://www.bluecrossma.com ) was founded more than 70 years ago by a group of community-minded business leaders. Today, headquartered in Boston, BCBSMA provides coverage to more than 3 million members, 2.5 million in Massachusetts. BCBSMA believes in rewarding doctors and hospitals for delivering safe and effective care, and in empowering patients to take more responsibility, become educated health care consumers and become stronger partners with their doctors. Blue Cross Blue Shield of Massachusetts is an independent licensee of the Blue Cross Blue Shield Association.

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