Check it out, straight from the Boston Globe:

Blue Cross and Blue Shield of Massachusetts wants to stop paying doctors and hospitals for each patient visit or treatment, a common arrangement that most experts agree has led to unnecessary, inefficient, and fragmented care that is sometimes harmful to patients.

Instead, they want to pay doctors and hospitals a flat sum per patient each year, adjusted for age and sickness, plus a significant bonus if the providers improve care, Blue Cross officials said. In most cases, the payment would cover all services from primary care doctors, specialists, counselors, and hospitals – forcing them to work together closely.

While driving to a meeting this morning, I heard Paul Levy, of BIDMC and Running a Hospital fame, and Andrew Dreyfus of BCBSMA, chatting about this new optional contract on the radio.  Have a listen, and check out today’s post at CommonHealth, too.

Let’s hope the variations on the theme this time around entice some providers to opt in — the more data, on the more variations, the merrier.

Update 1/23/08:  The variations this time around include, as Andrew noted in a follow-up comment to yesterday’s post at Commonhealth, fixed payments (which conjure up organized medicine’s rationing bogeyman), coupled with incentive payments based on quality measures (which should help put it to rest).

David Harlow