Leaders argue the move to global payments will correct the problem of fee-for-service, which rewards physicians for seeing the most patients or ordering the most tests. Instead, physicians at Beth Israel will receive a budget to care for 75,000-80,000 Blue Cross HMO patients. If the group goes over-budget, they split the loss with Blue Cross. If they come under budget, they share the surplus.
Physicians will not enjoy a share in the surplus if no improvements are shown in patient conditions or preventative tests. According to the report, the move will shift resources from primary care to specialists, causing some anxiety from Beth Israel physicians.
The Beth Israel physician group is the largest physician group to sign the “Alternative Quality Contract” with Blue Cross since the insurer started pushing for the contract two years ago, according to the report.
Read the WBUR report on Beth Israel Deaconess Medical Center.
Read more on pay-for-performance and fee-for-service:
–CMS Awards $814K in Pay-for-Performance to 9 North Shore-LIJ Hospitals
