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Revolution in Mass. insurance system

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Yet again, Massachusetts is  a pacesetter for health-insurance reform.

The Boston Globe reports that Blue Cross Blue Shield of Massachusetts ”will vastly expand its system that pays doctors based on how well they care for patients {aka fee for value}— not just for the number they see and volume of services they provide {aka fee for service}. The move will extend the quality-based system to more than 1 million health plan members, making it the biggest initiative of its kind in the state and probably the country.”

”The move by Blue Cross, which controls 40 percent of the state’s commercial insurance market, should hasten the decline of the way American doctors have been paid for decades, analysts said”.

The Globe elaborated: “Blue Cross will essentially pay doctors a set amount to care for their patients but payments will ultimately be tied to how well doctors and hospitals score on a variety of quality measures.

”For consumers, the change will mean more coordinated care and management, such as follow-up visits by home aides after surgery and phone calls to make sure patients take their medicine.”


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