You need them to pray you don't get sick.
"Blue Cross CEO says providers must control costs, or else; Insurer pushes for switch to new payment system" by Robert Weisman, Globe Staff / January 23, 2011
The chief executive of Blue Cross Blue Shield of Massachusetts, the state’s largest health insurer, is calling on hospitals and doctors to step up efforts to contain health care costs, warning that those insisting on traditional fee-for-service contracts will face level or reduced payments from his company.
Andrew Dreyfus, who took the helm at Blue Cross Blue Shield in August, last week sent a letter to more than 400 leaders of hospitals and physicians practices, applying pressure on them to switch to a global payment plan. Under such a system, medical care providers are put on an annual budget and given incentives to control costs and improve care instead of being paid for individual doctors visits and procedures.
Sounds like rationing.
See: The Massachusetts Model: Trailblazing Blueprint
Maybe you want to find another way, American.
Dreyfus, who once worked in state government and for the Massachusetts Hospital Association, said Blue Cross Blue Shield will take a hard line in negotiations with hospitals and doctors that don’t agree to accept global payments....
Blue Cross, which insures nearly 3 million state residents, has an outsized influence on employers and health care providers. Dreyfus’s letter acts as “both a threat and a promise,’’ said Stuart H. Altman, health policy professor at Brandeis University. “He’s saying to the hospitals, you can do better under global payments. But he’s also saying, if you don’t want to do it, if you’re more comfortable with the fee-for-service system, forget it, we’re going to come down on you.’’
Massachusetts employers have long chafed at annual double-digit premium increases, with most blaming Blue Cross and other insurers for the relentless trend that crimps hiring by raising employee costs.
At the same time, nonprofit hospitals are being financially squeezed by cuts in Medicaid and other government payments. Community hospitals and smaller academic medical centers say they can’t command the same reimbursement rates granted by insurers to dominant market players such as Partners HealthCare System and Children’s Hospital Boston.
Related: Partners No More
But officials at hospitals large and small agree that Dreyfus has sent a wake-up call.
“What Blue Cross is basically saying is it’s not going to be about (market power) any more,’’ said Ken Hanover, chief executive of Northeast Hospital Corp., which owns Beverly Hospital and Addison Gilbert Hospital in Gloucester. “It’s going to be about quality and managing the cost of care. This is going to require a significant restructuring of the Massachusetts health care delivery system.’’
And it already stunk. It's probably going to turn into another RMV situation.
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Dreyfus also acknowledged there is a public perception that Blue Cross executives have been overcompensated. To counter that, he said, he has asked that his salary be limited to $800,000 this year, in addition to incentive pay if he meets certain corporate goals.
That is not changing my perception at all.
His predecessor, Cleve L. Killingsworth, was paid $1.9 million in 2009, and before him, William C. Van Faasen collected more than $16 million in retirement benefits when he stepped down as chief executive in 2005. Van Faasen is now board chairman....
Related: The Massachusetts Model: Blue Cross Turns Green For Killingsworth
The Massachusetts Model: Blue Cross Drops Its Shield
Also see: Blue Cross Sitting on Billions in Surplus
But they can't the fee for your service, 'eh?
Blue Cross has moved about 40 percent of its health maintenance organization members to the so-called AQC, one of the nation’s biggest private-sector pilot projects for global payments....
Related: Return of the HMOs
Obama's HMOs
A rose is still a rose....
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"Blue Cross Blue Shield of Massachusetts says its new system of paying doctors a fixed amount per patient improved care during the first year, contrary to critics’ fears that patients would be harmed....
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Then what is Dreyfus complaining about?
