BCBS of Massachusetts launches global payment model for primary care clinics

Blue Cross Blue Shield of Massachusetts will pilot a new payment model for primary care practices next year. 

The pilot will use a global payment model. Under the mechanism, primary care practices will receive a pool of money to use for patients, rather than payment for each office visit, test or procedure. Primary care clinics will receive incentive payments if they meet certain quality targets, like the percentage of pediatric patients receiving vaccinations, and lower costs. Conversely, if these outcomes aren't met, they will earn less. 

Global payments aren't new for BCBS of Massachusetts. A 2019 study published in The New England Journal of Medicine found BCBS of Massachusetts' global budget payments slowed down spending growth while improving healthcare quality — achieving what BCBS of Massachusetts' CEO referred to as the "holy grail in healthcare": higher quality at a lower cost. 

Zirui Song, MD, PhD, assistant professor of healthcare policy at Harvard Medical School in Boston and a primary care physician at Massachusetts General Hospital, said the new model is "an important advancement in our collective thinking about financing primary care, especially the care delivered by independent, privately owned primary care practices in the communities that need the most help during these difficult times." 

The initial rollout of the model will be limited and paced to monitor results. 

Read more about the model here.

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