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. 2015 Dec;34(12):2077-85.
doi: 10.1377/hlthaff.2015.0685.

The Early Impact Of The 'Alternative Quality Contract' On Mental Health Service Use And Spending In Massachusetts

Colleen L Barry  1 , Elizabeth A Stuart  2 , Julie M Donohue  3 , Shelly F Greenfield  4 , Elena Kouri  5 , Kenneth Duckworth  6 , Zirui Song  7 , Robert E Mechanic  8 , Michael E Chernew  9 , Haiden A Huskamp  10
Affiliations

The Early Impact Of The 'Alternative Quality Contract' On Mental Health Service Use And Spending In Massachusetts

Colleen L Barry et al. Health Aff (Millwood). 2015 Dec.

Abstract

Accountable care using global payment with performance bonuses has shown promise in controlling spending growth and improving care. This study examined how an early model, the Alternative Quality Contract (AQC) established in 2009 by Blue Cross Blue Shield of Massachusetts (BCBSMA), has affected care for mental illness. We compared spending and use for enrollees in AQC organizations that did and did not accept financial risk for mental health with enrollees not participating in the contract. Compared with BCBSMA enrollees in organizations not participating in the AQC, we found that enrollees in participating organizations were slightly less likely to use mental health services and, among mental health services users, small declines were detected in total health care spending, but no change was found in mental health spending. The declines in probability of use of mental health services and in total health spending among mental health service users attributable to the AQC were concentrated among enrollees in organizations that accepted financial risk for behavioral health. Interviews with AQC organization leaders suggested that the contractual arrangements did not meaningfully affect mental health care delivery in the program's initial years, but organizations are now at varying stages of efforts to improve mental health integration.

Keywords: Financing Health Care; Mental Health/Substance Abuse; Organization and Delivery of Care.

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References

    1. Berwick DM, Nolan TW, Whittington J. The Triple Aim: care, health, and cost. Health Aff (Millwood) 2008;27(3):759–69. - PubMed

    1. To access the Appendix, click on the Appendix link in the box to the right of the article online.

    1. Song Z, Rose S, Safran DG, Landon BE, Day MP, Chernew ME. Changes in health care spending and quality 4 years into global payment. N Engl J Med. 2014;371(18):1704–14. - PMC - PubMed
    1. Song Z, Safran DG, Landon BE, He Y, Ellis RP, Mechanic RE, et al. Health care spending and quality in year 1 of the alternative quality contract. N Engl J Med. 2011;365(10):909–18. - PMC - PubMed
    1. Song Z, Safran DG, Landon BE, Landrum MB, He Y, Mechanic RE, et al. The ‘Alternative Quality Contract,’ based on a global budget, lowered medical spending and improved quality. Health Aff (Millwood) 2012;31(8):1885–94. - PMC - PubMed

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