The search for value healthcare is taking a new turn as Blue Cross Blue Shields of Massachusetts forces hospitals to realign their strategies from a focus on efficiency to one on patient outcomes.

As the largest payer in the state, BCBS is incentivizing hospitals to keep patients out of hospital beds. The future of this pilot program at South Shore Hospital is still uncertain, but it looks promising.

Video Spotlight: Value-Driven Outcomes: A program to reduce hospital costs

This post is based on the Boston Globe article, Blue Cross Wants To Reward Hospitals – For Keeping Patients Out of Hospitals, by P. Dayal McClusky, October 29, 2018, and the KSAT video, Value-Driven Outcomes: A program to reduce hospital costs, by Ivanhoe Newswire, January 27. 2017. Image source: Comstock/Getty Images.

Discussion Questions:

1. How is the new program supposed to bring more value to the patient?

Guidance: According to Michael Porter (2013, p. 52), value is “health outcomes achieved that matter to patients relative to the cost of achieving those outcomes.” To insured patients, the monetary costs include premiums, deductibles, and co-payments. Hospital cost increases are transferred to patients through higher premiums and other out-of-pocket expenses. As Continue reading →