Wednesday, April 08, 2015

Revisionist history

We can have proper debates about the public policy merits of capitated, or global, payments, but things get dicey when the biggest protagonist of such in Massachusetts tries to restate history.  In this article by Brant Mittler about Blue Cross Blue Shield of Massachusetts, there is this excerpt:

Levy said that others signed because they received "very sweet signing bonuses" -- in the form of front-loaded contracts which would be more palatable to providers.

Dana Safran, DSc, the plan's senior vice president for performance measurement and improvement, calls the idea that contracts were front-loaded "not accurate."

And yet, let's look at the contemporaneous reporting (Spring 2011) from Bruce Mohl at Commonwealth Magazine:

Safran says Blue Cross padded first-year global payment budgets to entice hospitals and doctors to sign on.

There is no indication that BCBS asked for a correction of this quote at the time or any time since.

I also know from personal conversations at the time with early adopters that they received substantial bonus payments from BCBS.  Indeed, at least one major provider organizer received a retroactive payment, going back almost a year--this for a pricing regime that was supposed to influence behavior.  Hard to influence behavior after it's already occurred, no?

If they can't tell the truth about this, how can we believe the other claims?

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