The Mass BC/BS Proposal

Marketplace, public radio's evening business show, earlier this week covered a plan by Massachusetts Blue Cross/Blue Shield to pay a flat fee for episodes of care -- such as a heart attack -- with bonuses attached for positive outcomes. The idea is to encourage hospitals and physicians to get it right the first time and ensure that patients, once released from the hospital, follow through on taking medicine and following doctors' instructions.

I spent a half hour on the telephone with reporter Stacey Vanek-Smith supporting the concept. As this blog has noted many times, good health care is about quality, not quantity. But I also noted that flat fee schedules could be an excuse for unscrupulous providers to stint on care for difficult cases that ran over the designated amount, and that such plans needed to be carefully regulated to avoid that scenario. As I know well from my years in the business, journalistic time slots are short and one must always have "the other side." My caveats were all that made it into the report. Hear for yourself here.