An updated Blue Cross Blue Shield of Massachusetts policy blindsided a patient recently because it would not cover the full cost of a her mastectomy, saying removing the breast without cancer was unnecessary.
It was a tough 2014 for three of Massachusetts' largest insurers.
The alternative quality care contract that Blue Cross Blue Shield of Massachusetts has had in place since 2009 could serve as a payment reform "backbone" for other insurers as they increasingly reward quality, efficient care, according to a new report from Avalere Health.
The CEO of Blue Cross Blue Shield of Massachusetts remains convinced the healthcare industry can rein in costs in a way that pleases both political parties, The Boston Globe reported.
FierceHealthPayer spoke with BCBSMA Senior Vice President of Performance Measurement and Improvement Dana Gelb Safran to find out how the insurer continues to use global payments to cut medical costs and improve patient care.
Through a precertification program launched in 2012, Blue Cross Blue Shield of Massachusetts reduced prescriptions for opioids such as Percocet by 20 percent and halved the prescription volume for longer-lasting painkillers such as OxyContin, The Boston Globe reported.
Massachusetts has had the highest per capita health spending for more than a decade, and a new comprehensive report shows provider pricing has driven this disproportionate increase in costs.
Insurers operating in Massachusetts recently warned businesses that their costs will likely increase between 5 percent and 8 percent this year.
Under a first-of-its-kind law implemented in Massachusetts in October, insurers must give consumers prices for certain services within two working days so consumers can comparison shop for medical procedures
There's no mistaking the fact that healthcare costs continue to rise regardless of whether quality of care improves. So the Commonwealth Fund examines if it's possible to get better care at lower costs, analyzing several payment reform initiatives already underway.