What if health care costs can be controlled? Blue Cross in MA set up a global payment system where doctors are compensated through a budget system. A doctor or medical center is given a budget to meet for the care of their patients, regardless of what tests, number of visits and everything else. If they go over budget, they need to reimburse the insurance company, if they are under budget, they are rewarded. They can save money on patients by ordering tests at cheaper facilities or reducing the number of tests ordered.
"Physicians also earn bonuses of 2 percent to 10 percent of their budget
for providing good care. Blue Cross monitors quality indicators, such as
whether doctors control patients’ blood pressure, provide regular
check-ups to children, and prescribe appropriate and timely medications
for depression. Compared to the control group, doctors with the
alternative contract improved care for chronically ill adults and
preventive care for both adults and children more quickly, the
I am glad to see this kind of system. It proves that costs can be controlled.
But it also makes me wonder - what kind of care were these doctors providing before? Were they just ordering too many tests? Not looking at costs? I do not assume they were doing anything intentionally wrong but if costs can be controlled so easily with out any drastic cuts in services and with healthier patients overall, something must have been wrong.
Hmmm... something to think about.
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