Capitation advances in Massachusetts

Today’s Managing Health Care Cost Indicator is 1.2 million

Click image to enlarge.  Source 

Yesterday’s Boston Globe reviews the advance of capitation in Masachusetts, pointing out that 1.2 million residents are now in “cost controlled” health coverage. Strikingly, the word “capitation” appears nowhere in the story.

The initial evaluation of the largest capitation arrangement, Blue Cross Blue Shield of Massachusetts’ “Alternative Quality Contract,” showed improvement in quality measures and a net increase in cost in year one.  This is no surprise given that BCBSMA has had to induce reluctant providers to join.  Capitated Medicare Advantage plans have been in place for almost two decades, and have been successful at lowering health care resource costs while maintaining high rates of patient satisfaction.

Governor Deval Patrick has called for a transition away from fee for service payment.   It looks like this is happening even absent legislative action. Hopefully, other payers will be as diligent as BCBSMA at reporting the results of this payment reform.

2-2-12 Addendum: Nathan Punwani has pointed out that Medicare Advantage plans have not generally saved money.  I should have said that groups accepting capitation in Medicare Advantage plans have been able to save money and lower costs.  See this post for an example.