Massachusetts Blue Cross Blue Shield To Begin Giving Physicians Bonuses for Quality Care
Blue Cross Blue Shield of Massachusetts in January will begin awarding bonuses to physicians who provide above-average quality of care to patients for less money, the Boston Globe reports. Beginning Jan. 1, Blue Cross Blue Shield will offer bonuses to more than 8,000 physicians -- about half the doctors in the insurer's HMO plan -- who meet specific quality-of-care standards. The incentive program is "part of a national movement" by employers and health plans to "shift the way" managed care rewards doctors and to increase compensation for the best-performing doctors, the Globe reports (Kowalczyk, Boston Globe, 12/17). Last month, several large employers and hospital networks in Massachusetts announced plans to offer physicians quality-of-care bonuses (Kaiser Daily Health Policy Report, 11/7). And in October, six HMOs in California announced similar plans (Kaiser Daily Health Policy Report, 10/31). However, Blue Cross Blue Shield's program differs from some other bonus programs because the insurer will offer incentives to physicians who provide quality care while controlling costs better than their colleagues; most bonus programs offer incentives if physicians simply meet specific quality standards. In addition, Blue Cross Blue Shield will pay bonuses to doctor groups rather than to individual physicians. Under the program, physician groups can earn up to 15% in addition to their regular fees. They will be measured in three categories: patient satisfaction and access, quality of care and cost. Groups whose costs increase less than average will receive a bonus and those who perform better than average on quality, satisfaction and access measures will earn an additional bonus. Deborah Devaux, vice president of Blue Cross Blue Shield provider contracting, said, "We think this is the responsible thing to do. Right now we're not paying the high-performing doctors enough, while we're paying too much to everyone else."
Raising Concerns
However, some physicians are "extremely worried" about the "implications" of the program, the Globe reports. Dr. Charles Welch, president of the Massachusetts Medical Society, expressed concern that insurers are simply "holding back money" that would have otherwise been used for regular reimbursement fees and are requiring doctors to earn that portion of their salary back through bonuses, the Globe reports. Further, some physicians have questioned insurers' methods of measuring quality and whether the bonuses will be substantial enough to motivate doctors. But Dr. Richard Parker, medical director of the Beth Israel Deaconess Physicians Organization, said that the program "encourages doctors to be doing what they should be doing and already are doing, but help us do it even better." Blue Cross and Blue Shield hopes to eventually enroll every physician in its network in the program (Boston Globe, 12/17).
