Right now, most insurers like Blue Cross Blue Shield of Massachusetts, for the most part, pay doctors and hospitals for the quantity, not quality, of the care patients receive. It's known as "fee-for-service." In other words, the more office visits, tests, and procedures a patient receives, the higher the payments to doctors and hospitals. At the same time, the fee-for-service system undervalues primary care, which can prevent and manage acute and chronic illness. This needs to change. As the science of measuring health care quality continues to improve, doctors and hospitals should be paid and rewarded on the basis of a patient's clinical outcomes.

In 2008, we introduced a new contract option for doctors and hospitals known as the "Alternative Quality Contract" or AQC. It pays doctors and hospitals based on the quality and outcome of the care they provide to our members.

The prestigious Commonwealth Fund, one of the nation's leading foundations for health care improvement, recommends "we move away from fee-for-service and toward ... payment systems that reward coordinated, high-value care."

Dr. Don Berwick, one of the foremost experts on health care quality, and the head of The Institute for Healthcare Improvement, said we need to "change the rules, decouple profits from volume, and reward better health achieved through an elegant frugality of means..."

President Barack Obama called for just such a change in the health care payment system in a news conference on March 24, 2009.

A number of physician leaders and hospital executives support our efforts to change the payment system. Listen to what two Massachusetts health care executives have to say about the AQC.

Our AQC Partners

Several pioneering health care organizations in Massachusetts have signed the AQC, including: Atrius Health; Caritas Christi Health Care; Mount Auburn Hospital and its affiliated physician group, Mount Auburn Cambridge Independent Practice Association; Tufts Medical Center and its network of affiliated physicians, the New England Quality Care Alliance; Signature Healthcare Corporation in Brockton; Lowell General Hospital and its affiliated physicians in the Lowell Physicians' Hospital Organization; and Hampden County Physician Associates.

Read what a number of other influential people have to say about the AQC.