Could changing the way doctors are paid help narrow health disparities?

Could changing the way doctors are paid help narrow health disparities?

The Boston Globe reports, A Harvard Medical School study suggests that changing the way doctors are paid could narrow some of the health disparities between poorer and wealthier patients.

Poverty has long been linked to poorer health, an intractable problem that health care experts have long sought to address. The study suggests that one solution may lie in the way health care providers are compensated by insurers.

The paper, published Monday in the journal Health Affairs, studied one type of coverage offered by Blue Cross Blue Shield of Massachusetts. The contract links what physicians are paid to dozens of health care quality measures. When patients score high on those measures and doctors stay under budget, they earn more money.

The study found that quality for all patients in the Blue Cross contract improved, but the gains were greater for poorer patients. The findings appear to be the first of their kind in health policy. The improvement largely was in access to care, such as medical checkups, cancer screenings, and blood pressure checks. Experts believe this type of preventive care can help avoid difficult and costly health problems down the road.

“Longstanding disparities in health care quality and health outcomes for poorer patients — we saw those disparities close,” said Dana Gelb Safran, senior vice president of performance measurement and improvement at Blue Cross, the largest commercial health insurer in the state. Safran worked with Harvard researchers on the study.

The findings, though limited to members of just one insurer, suggest that the way payments are structured has the potential to improve the health of those who need care the most. That is a promising sign as other health insurers, Medicare, and Medicaid continue to the move to so-called alternative or accountable care models, which tie payments to budgets and quality scores.

“This is an important finding,” said Dr. Mark Friedberg, senior natural scientist at the Boston office of RAND Corp., a research organization.


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The Boston Globe – Could changing the way doctors are paid help narrow health disparities?

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