Bargain Basement Medicine in Massachusetts

Bargain Basement Medicine in Massachusetts

Patient: ”Doctor, it hurts when I do this.” Doctor: ”Well, don’t do that!” (old medicine, simplified)

Patient: “Doctor, it hurts when I do this.” Doctor: “Well, if you do that, I can’t do much for you since you’ve already cost too much this month. Maybe come back next month and I’ll see what I can do. And, if you must be hospitalized, I know this nice, cheap hospital I can send you to.” (new Massachusetts medicine, simplified)

Fear not, though, it’s all good in the Bay State: “Blue Cross/Blue Shield of Massachusetts says its new system of paying doctors a fixed amount per patient improved care during the first year, contrary to critics’ fears that patients would be harmed.”

Its “new system” is saving BC/BS of MA a ton of money but that fact has absolutely no bearing on the results of its 2009 new system evaluation. The aim of the pilot program was to cut the annual rate of medical cost increases from 10-12% to 5-6% and, Eureka, it’s working!

The proof is in the paying: “Doctors at Signature Healthcare in Brockton reduced avoidable emergency room visits 25 percent, from 2,249 in 2008 to 1,685 in 2009, saving $300,000 in payments to hospitals. . . Doctors in the alternative contract also reduced hospital readmissions, saving $1.8 million, while readmissions among patients of other doctors grew,” according to Blue Cross calculations.

That’s the good news, good news for BC/BS of MA. The bad news is reserved for doctors and patients: “Doctors who have agreed to the ‘alternative quality contract’ are paid a set monthly fee per patient, adjusted for how healthy the patient is, regardless of how many tests, appointments, and procedures the patient gets.” In other words, physicians are compensated with that set fee for the care they render no matter how much care is necessary or rendered. . .
(Read more at http://www.genelalor.com/blog1/?p=3480)