Michael E. Chernew, PhD
Professor of Health Care Policy, Department of Health Care Policy, Harvard Medical School
For this seminar, Dr. Chernew will provide updated research analysis on the second phase of the study described below, which appeared in the New England Journal of Medicine, published online July 13, 2011.
In 2009, Blue Cross Blue Shield of Massachusetts implemented a global payment system called the Alternative Quality Contract (AQC). Provider groups in the AQC assume accountability for spending, similar to Accountable Care Organizations that bear financial risk. Moreover, groups are eligible for quality bonuses. Analyzed were 2006-2009 claims for 380,142 enrollees whose primary care physicians (PCPs) were in the AQC (intervention) and 1,351,446 enrollees whose PCPs were not (control). Findings showed that average spending increased for both AQC and non-AQC enrollees in 2009, but the increase was smaller for AQC enrollees. Savings largely derived from shifts in outpatient care toward facilities with lower fees, from procedures, imaging, and tests, and from subjects with highest expected spending. All AQC groups met 2009 budget targets and earned surpluses. Total BCBS payments to AQC groups, including quality bonuses, likely exceeded the estimated year-1 savings. The AQC was associated with modest slowing of spending growth and improved quality in 2009. The long-run AQC impact on spending growth depends on future budget targets and providers’ ability to further improve efficiencies in practice.
Dr. Chernew’s research examines several areas related to controlling health care spending growth while maintaining or improving the quality of care. He received his B.A. from the University of Pennsylvania, and his PhD in economics from Stanford University, where his training focused on areas of applied microeconomics and econometrics. He is the Co-Editor of the American Journal of Managed Care and Senior Associate Editor of Health Services Research. Dr. Chernew has served on the Editorial Boards of Health Affairs and Medical Care Research and Review. Dr. Chernew is also a Research Associate of the National Bureau of Economic Research. Dr. Chernew is a member of the Medicare Payment Advisory Commission (MedPAC), which is an independent agency established to advise the U.S. Congress on issues affecting the Medicare program. He is also a member of the Congressional Budget Office’s Panel of Health Advisors, the Institute of Medicine’s Committee on Determination of Essential Health Benefits, and The Commonwealth Foundation’s Commission on a High Performance Health Care System.
This seminar is free and open to the public, RSVP is not required.
Co-sponsored by the Department of Health Policy & Management, School of Public Health, U of MN
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