Skip to content Skip to navigation

Quality, Payment Initiative Positively Impacts Pediatric Care

December 24, 2013
by John DeGaspari
| Reprints
Contracting model, based on global payment and pay-for-performance, improves quality of care for sickest pediatric patients

Within two years of implementation, Blue Cross Blue Shield of Massachusetts' Alternative Quality Contract (AQC) had a small but significant positive effect on the quality of pediatric care, according to a study from Boston Children's Hospital. The results were published online Dec. 23 in the journal Pediatrics.

Blue Cross Blue Shield of Massachusetts implemented an AQC in 2009, offering providers a baseline budget to cover the continuum of care, while also awarding pay-for-performance bonuses for improved care quality metrics. According to Boston Children’s Hospital, this AQC was unique for including pediatric quality measures in its contract.

According to the study's lead author Alyna Chien, M.D., from Boston Children's Division of General Pediatrics, "Children, especially those with chronic or severe medical conditions, can contribute significantly to health care costs. If spending is to be contained, it's important to understand the impact of the AQC on children as well as adults."

Researchers compared the quality and cost of care provided to 126,975 cases within the AQC structure against 415,331 similar patients who were not in the AQC, across a study period from 2006 to 2010. Quality measures tied to pay-for-performance rates of preventive/screening care and acute care were analyzed, as was care of asthma and attention deficit disorder, which were not directly tied to bonuses.

After analyzing and aggregating all data, the researchers found the AQC had a small yet significant positive effect on preventive and acute care quality when tied to pay-for-performance models. Children with chronic illness experienced higher quality gains (up 1.8 percent) than children without chronic illness (up 1.2 percent). The AQC had no effect on quality measures not tied to the pay-for-performance model, nor did it have an effect on reducing overall health care costs for children.

 

Get the latest information on Finance and Revenues and attend other valuable sessions at this two-day Summit providing healthcare leaders with educational content, insightful debate and dialogue on the future of healthcare and technology.

Learn More

Topics

News

Allegheny Health Network, VA Pittsburgh Integrate EMR Systems

Allegheny Health Network (AHN), based in Pittsburgh, and VA Pittsburgh Healthcare System (VAPHS), have announced the successful integration of their electronic medical record (EMR) platforms.

Wisconsin Urology Group Notifies Patients of Data Breach Due to Ransomware Attack

Wauwatosa, Wis.-based Metropolitan Urology Group has notified its patients of a breach of unsecured patient health information due to a ransomware attack back in November 2016.

Study: For Post-Op Patients, Mobile Apps for Follow-Up Care Led to Fewer In-Person Visits

For patients undergoing ambulatory surgery, those who used a mobile app for follow-up care attended fewer in-person visits post- operation than patients who did not use the app, according to a study in JAMA Surgery.

Information Blocking is Routine and Fairly Widespread, Survey of HIEs Finds

In a survey, 50 percent of HIE leaders said electronic health record (EHR) vendors "routinely" engage in information blocking, and 25 percent reported that hospitals and health systems routinely engage in business practices that interfere with electronic health information exchange.

ONC Updates SAFER Guides to Address EHR Safety

The Office of the National Coordinator for Health IT (ONC) published updated safety best practices, called the Safety Assurance Factors for Electronic Health Record Resilience (SAFER) Guides, to identify recommended practices to optimize the safety and safe use of electronic health records (EHRs).

Survey: Healthcare Organizations Remain Underprepared for MACRA

Two-thirds of healthcare providers report that they are “unprepared” or “very unprepared” for managing and executing Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) initiatives, according to a survey from Pittsburgh-based Stoltenberg Consulting Inc.