BCBS of Massachusetts AQC improved quality, lowered costs: 10 things to know

In its first four years of implementation, the Blue Cross Blue Shield of Massachusetts Alternative Quality Contract, which focuses on improving quality of care, helped slow spending growth and improve quality performance, according to a Harvard Medical School study published in the New England Journal of Medicine.

For the study, the researchers evaluated quality measures and spending during the first four years of the AQC for enrollees whose physician organization entered the AQC from 2009 through 2012.

The researchers compared financial and quality results from the 2009 through 2012 cohorts with control group results. The control group was comprised of commercially insured people in employer-sponsored health plans across Connecticut, Maine, New Jersey, New Hampshire, New York, Pennsylvania, Rhode Island and Vermont in Truven Health Analytics' Commercial Claims and Encounters database.

Here are 10 findings from the study.

1. Unadjusted claims spending slowed for the 2009 AQC cohort after entering into the risk-based AQC, as compared to the control group.

2. For the 2010 ACQ cohort, unadjusted medical spending per enrollee per quarter grew 8.8 percent less than the control group.

3. Unadjusted medical spending per enrollee per quarter for the 2011 cohort grew 9.1 percent less than the control group.

4. For the 2012 ACQ cohort, unadjusted medical spending per enrollee per quarter grew 5.8 percent less than the control group.

5. Medical spending grew an average of $62.21 per enrollee per quarter less in the AQC cohorts than the control group over the four years, which is a savings of approximately 6.8 percent. 

6. Over the 4-year period, the most pronounced areas of savings for the AQC cohorts were in the outpatient setting, including a 19.3 percent reduction in facility spending. 

7. The 2009 AQC cohort's average performance on measures of chronic disease management was 79.6 percent for the period of 2007 to 2008, which increased to 84.5 percent in the period from 2009 to 2012. The HEDIS national average for 2007 to 2008 was 79.8 percent, and the national average for the period of 2009 to 2012 was 80.8 percent.

8. The 2010 and 2011 cohorts also saw increases in performance as compared with HEDIS.

9. The 2012 cohort did not improve as compared to HEDIS during the first year, as it had a higher level of performance to begin with.

10. When compared with similar populations in other states, the Massachusetts AQC enrollees had lower spending growth and generally greater quality improvements after four years.

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