Question

• Concerns about the rise of health care costs continues to dominate the health policy agenda in the US. There are many efforts in place to control costs. In a 200 word post, discuss one type of cost control that is currently used to try to stop the continued rise of costs.

Please be sure to validate your opinions and ideas with citations and references in APA format.

Urgent need

Answer 1

There are several ways that put emphasis on using money more wisely. These activities include:

Elevating the experience for beneficiaries.

Incenting care that is less fragmented and more coordinated, and that results in a decrease in unnecessary services. This includes using the ACO model, bundling payments, penalizing readmissions, and better managing transitions.

Emphasizing strong primary care.

Focusing on prevention and wellness.

Correcting spending distortions and keeping per beneficiary cost growth low.

Piloting improved coordination for dual eligibles. Paying for quality, which entails aligning the many measures of quality.

Taking advantage of the wealth of data held by CMS. CMS is working to modernize its approach to storing, analyzing, and disseminating data. CMS has established a “data shop” and plans to use data to decrease costs.

Type of cost control that is currently used to try to stop the continued rise of costs:

BlueCross BlueShield of Massachusetts’ Alternative Quality Contract (AQC). BCBSMA recognized that most of the decisions about care are made by physicians and wanted to reinvent payment in a way that physicians would embrace. The goal was to create a new payment model that drove significant changes in delivery, with better quality and cost results. The AQC is a deep partnership between the plan and physicians, according to Andrew Dreyfus. Structured as a five-year commitment, it avoids adversarial negotiations, provides adequate time to invest, and involves a significant health status adjustment. Practices are being redesigned, referral and care patterns are changing, quality is up significantly, and resource use is down.