Healthcare Savings: Dumb Luck vs. Progress

December 4, 2014
James Doulgeris

BCBS of Massachusetts' quality and cost experiment touts spending reductions that insult physicians' intelligence.

A recent Boston Globe article quotes Andrew Dreyfus, Blue Cross Blue Shield of Massachusetts' chief executive, with a statement that touted the dawn of a solution to the nation's core healthcare problems: mediocre quality and clinical outcomes at the world's highest cost. "Now we have the results of four years of one of the biggest, if not the biggest, payment reform initiatives in the nation, that show we are approaching the holy grail of health care, which is better care at lower costs," said Dreyfus.

This would be great news for all Americans except for something that needs just a bit of thought to put into perspective; "…spending for patients in Blue Cross Blue Shield of Massachusetts' Alternative Quality Contract grew 10 percent slower than for patients in traditional plans."

Wait, what does the analysis on BCBS' program published in the New England Journal of Medicine by researchers at Harvard Medical School really say?

Costs in this massive 680,000 patient at-risk program designed to deliver higher quality and results at lower cost still increased, culminating after four years of effort and experience, to slow health cost inflation to a pathetic 90 percent of the rate of increase in cost experienced the other 2.1 million BCBS patients receiving traditional medicine.

Dana Gelb Safran, a senior vice president at Blue Cross who was involved with the study, said that these results "may be useful to policymakers, insurers, and providers embarking on payment reform."

Safran nails it dead center with this understatement. Local, state, and national legislators, policymakers, insurers, providers and self-insured employers, pundits, and the press need to pay very close attention to the message and touting results so transparently poor as to be far within the margin of dumb luck instead of progress. The American public wants and deserves actual improvement, and this isn't it.

One more thing. Americans, as poorly as our educational system compares to the rest of the developed world, can still do math.

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