Abstract
To contend with rising health care spending, in 2009 Blue Cross Blue Shield of Massachusetts (BCBS)--the state's largest commercial payer--implemented a global payment model called the Alternative Quality Contract (AQC). Under the AQC, BCBS pays health care providers a comprehensive, global payment rather than reimbursing them on a fee-for-service basis. The global payment covers the entire continuum of a patient's care, including inpatient, outpatient, rehabilitation, long-term care, and prescription drugs. In addition, providers are eligible for a performance bonus if they meet certain quality targets. In this study, researchers looked at spending and quality improvement for BCBS patients whose primary care providers participated in the ACQ, and also for a control group of patients whose providers were not in the AQC. This study evaluated the first year of the five-year contract.