Harvard Med: BCBS of Massachusetts' global payments may slow spending growth

Blue Cross Blue Shield of Massachusetts' global budget payments were associated with lower spending and higher quality of care, according to a recent study published in The New England Journal of Medicine

Rather than paying for each service, global payments give physicians an overall spending budget for a group of patients. Under the capped payment model, the goal is to incentivize physicians to use more preventive care and cut back on services that are more wasteful.

Led by researchers from Boston-based Harvard Medical School, the study examined quality and claims data from BCBS from 2006-16. Researchers compared spending among BCBS members whose physicians entered global payment contracts in 2009 with spending among the privately insured in control states.

During the eight-year period, medical spending for BCBS of Massachusetts members under the global payment contracts was, on average, $461 lower per enrollee than in control states. That's a 12 percent relative savings on claims, according to the study authors. Quality measures among these members also improved when compared to control states.

"Healthcare costs are high, and they continue to grow nationwide," study author Zirui Song, MD, PhD, assistant professor of healthcare policy and of medicine at Harvard Medical School, said in an article for the university. "The evidence we found suggests that this global payment program has slowed the growth of spending on claims, improved several aspects of quality relative to regional and national averages, and changed some dimensions of provider behavior in a potentially sustainable way."

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