Zirui Song, Sherri Rose, Michael. E. Chernew, and Dana Gelb Safran
Z. Song, S. Rose, M. E. Chernew et al., “Lower- Versus Higher-Income Populations in the Alternative Quality Contract: Improved Quality and Similar Spending,” Health Affairs, Jan. 2017 36(1):74–82.
In 2009, Blue Cross Blue Shield of Massachusetts launched a population-based payment arrangement called the Alternative Quality Contract (AQC), which financially rewards physicians for improving the quality of patient care and holds them accountable for medical spending. Physicians who come in under budget by efficiently managing their patient populations share in the financial savings, while physicians who come in over budget must help cover the extra costs.
Past research has shown that the AQC improves quality scores and lowers overall spending. Commonwealth Fund–supported researchers explored whether the model also mitigates health disparities by boosting the quality of care provided to disadvantaged populations.
The researchers evaluated changes in quality performance and medical spending over a four-year period, comparing the impact on patients living in lower- and higher-income areas of Massachusetts. They found:
The AQC helped narrow health disparities between enrollees living in lower- and higher-socioeconomic areas. The AQC’s substantial financial incentives may have enabled providers to invest in outreach programs and other resources to help improve the health of disadvantaged populations.