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Blue Cross Blue Shield, Caritas Christi in pact

By Robert Weisman
Globe Staff / November 28, 2009

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Health insurance carrier Blue Cross and Blue Shield of Massachusetts and Boston’s Caritas Christi Health Care, a chain of six community hospitals in eastern Massachusetts, yesterday said they have signed a new five-year “alternative quality contract.’’

The contract includes a so-called global payment system in which hospitals will be paid fixed amounts based on the estimated annual costs of patients’ care instead of the fee-for-service system in which providers bill insurers for individual visits and procedures. It also includes incentives to improve the quality and affordability of care.

Covered under the contract will be about 1,100 Caritas-affiliated doctors who serve about 60,000 members of Boston-based Blue Cross Blue Shield. That will bring the most physicians from any organization into the alternative quality contract, a plan that covers more than 25 percent of Massachusetts-based members of the insurer’s health maintenance organization.

The alternative quality contract offered by Blue Cross Blue Shield is an example of the kind of global payment system under consideration by state government officials trying to stem the escalating costs of health care in Massachusetts.