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.

 

Health IT Summit Series - Focus: POPULATION HEALTH MANAGEMENT

Get the latest information on Patient Engagement, and attend other valuable sessions at this two-day, intimate event bringing together C-level, physician, practice management and IT decision makers for strategy discussions, knowledge exchange, and one-on-one meetings.

Boston, June 23-24   |   Denver, July 12-13
Topics

News

athenahealth Says it will Cover MIPS Payment Penalties for Customers

July 25, 2016
athenahealth has said that if customers using the company’s athenaOne services get hit with Merit-Based Incentive Payment System (MIPS) payment penalties, it will cover the financial consequences for those unsuccessful practices.

OIG Study Finds 60 Percent of Hospitals Experienced EHR Disruptions, Highlights Importance of Contingency Plans

July 25, 2016
Close to 60 percent of hospitals have experienced an unplanned disruption to their EHR systems and a quarter of those hospitals experienced delays in patient care as a result, according to a study released by the HHS Office of Inspector General (OIG).

University of Mississippi Medical Center Agrees to Pay $2.75M to Settle Potential HIPAA Violations

July 25, 2016
The University of Mississippi Medical Center (UMMC) has signed a resolution agreement with the U.S. Department of Health and Human Services Office for Civil Rights (OCR) following an investigation of a data breach of unsecured PHI that occurred in 2013.

HHS Grants $36M in Funding for Health IT Improvement

July 25, 2016
Health and Human Services (HHS) Secretary Sylvia M. Burwell has announced more than $36 million in funding for 50 Health Center Controlled Networks (HCCNs) that will aim to greatly increase health IT support across the country.

Study: Data-Driven Physiologic Alarm Parameters Can Help Reduce Alarm Fatigue

July 22, 2016
Alarm fatigue from clinical decision support systems is a significant hazard in hospitals. In a recent study, researchers found that tailoring bedside monitor alarm limits using data-driven physiologic parameters can mitigate alarm fatigue.

New CMS Initiative will Leverage Predictive Modeling to Prevent Heart Attacks and Strokes

July 22, 2016
A new program released by the Centers for Medicare & Medicaid Services (CMS) will aim to decrease cardiovascular disease risk by leveraging data analytics by assessing an individual patient’s risk for heart attack or stroke and applying prevention interventions.

Justice Department, State Attorneys General Sue to Block Anthem, Aetna Deals

July 21, 2016
The U.S. Department of Justice announced Thursday that the department, along with attorneys general from multiple states, filed lawsuits to block Anthem’s proposed acquisition of Cigna and Aetna’s pending acquisition of Humana.

Study: Large Health Systems Investing in Strategic Initiatives to Address Patients’ Social Needs

July 21, 2016
Several health systems have been investing core operating dollars to address the social needs of patients in order to improve overall health outcomes, and are integrating that work into core clinical systems, according to a new study from the Bridgespan Group.

Survey of Health IT Pros Reveals High and Frequent Stress Levels

July 21, 2016
A survey of approximately 500 health IT professionals by HealthITJobs.com has revealed that 55 percent of such professionals are frequently or constantly stressed, and 38 percent say their stress is high or extremely high.

Survey: 74 Percent of Physician Specialties Saw Increased Compensation in 2015

July 20, 2016
Average physician compensation increased 3.1 percent in 2015, with 74 percent of physician specialties experiencing increases, according to the latest AMGA Medical Group Compensation and Productivity Survey.

NCPA Senior Fellow Calls MACRA “A Poor Solution”

July 20, 2016
A report from the National Center for Policy Analysis (NCPA) has assessed that the "doc fix” contained in the Medicare Access and CHIP Reauthorization Act (MACRA) is fiscally irresponsible, and will only increase federal control over how doctors practice medicine.

Report Finds that Ransomware Attacks and Demands are on the Rise

July 20, 2016
The latest research paper on ransomware from the Mountain View, Calif.-based Symantec finds that the disturbing trend has now grown into one of the biggest dangers facing businesses and consumers today.

Rock Health: Digital Health Funding Remains Hot in 2016 Despite Expected Decline

July 19, 2016
The first half of 2016 has concluded with slightly over $2 billion in total digital health venture funding–on track with the levels of both 2014 and 2015, according to a midyear report from San Francisco-based Rock Health.

BREAKING: Justice Department to Challenge Anthem, Aetna Deals, Media Reports Say

July 19, 2016
Antitrust officials at the U.S. Department of Justice may file lawsuits to block health insurer Anthem’s proposed $54 billion acquisition of Cigna as well as Aetna’s pending $37 billion takeover of Humana, according to a Bloomberg article posted Tuesday.

ONC Issues Report to Congress on Policy Gaps for Security, Privacy of mHealth Data

July 19, 2016
The federal government needs to address large gaps in policies around health data access, security and privacy with regard to mobile health apps and health social media, according to a new ONC report issued to Congress.

Pages