Blue Cross Blue Shield of Massachusetts CEO Andrew Dreyfus said in the report that health insurers in the state are giving larger increases to the lower-paid hospitals, while the bigger hospitals are seeing smaller increases or even decreases in payment rates.
Tufts Health Plan CEO said healthcare costs can be controlled in the state “by applying rate decreases or rates of increase well below inflation for providers that are above the market average while negotiating incrementally higher rates of reimbursement for providers who are reimbursed below our network average,” according to the report.
Recently, Children’s Hospital Boston — one of the largest pediatric hospitals in the country — signed an “Alternative Quality Contract” with BCBS of Massachusetts in which it would receive no payment rate increase this year and only modest increases (less than 3 percent) in 2013 and 2014. The AQC rewards the hospital and physicians for quality measures and managing chronic illnesses, similar to a shared savings program.
Related Articles on Hospital-Payor Relationships:
Two New Jersey Hospitals Dump UnitedHealthcare, Aetna
Blue Shield of California Asks UCLA Medical Center to Stop “Relentless Rate Increases”
Beaumont Health System Plans to Stop Accepting Insurance From BCBS HMO
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