Study Finds New Payment Models May Potentially Reduce Health Care Disparities

January 2017 ~

A new study from Harvard Medical School which found “meaningful” improvements in quality, outcomes, and spending for all patients in the Alternative Quality Contract (AQC) between suggests binding insurers’ physician payments to quality metrics can narrow disparities between low- and higher-income patients.

The study, published in the January edition of Health Affairs, compared changes in clinical quality, health outcomes, and total spending between members with lower and higher socioeconomic status (SES) before and after their physicians entered the AQC.

Researchers found “meaningful” improvements in quality, outcomes, and spending for all patients in the AQC between 2007 and 2012. The authors suggest the improvements among low-income patients were partly related to the “sizeable incentives for quality under the AQC.”

The authors note that while spending for lower and higher SES patients in the AQC was similar, quality improvements were greater for lower SES patients in the AQC compared to higher SES patients.

The report concludes that given the right incentives, the findings suggest that providers serving more vulnerable populations can be as successful as providers serving more advantaged populations.

“Quality improved across the board for members in the AQC, but we noticed a larger improvement for members from lower socioeconomic backgrounds,” said coauthor Zirui Song. “This is encouraging because it suggests that payment models like the AQC, which offers significant rewards for performance on quality, outcomes, and cost, could motivate providers to focus on improving care for disadvantaged populations.”

Michael Chernew, one of the study’s coauthors, noted, “There is a legitimate concern that disadvantaged populations could suffer under new payment models. These results allay, but do not eliminate, those concerns. The details of each payment program will matter, so continued evaluation is important.”

According to coauthor and Blue Cross Chief Performance Measurement & Improvement Officer Dana Gelb Safran, “This latest study is an exciting follow-up because it shows that the AQC has not only improved quality of care, but that it has helped to close longstanding health disparities between patients who are socioeconomically vulnerable versus their more advantaged counterparts.”


Source(s): American Health Line; HealthAffairs; Boston Globe; Blue Cross Blue Shield of Massachusetts;