This blog post, by Andrew Dreyfus, the executive vice president for health care services at Blue Cross Blue Shield of Massachusetts and former president of the Blue Cross Blue Shield of Massachusetts Foundation, caught my eye.

Commonhealth » Blog Archive » A NEW AND DIFFERENT WAY TO PAY FOR CARE by Andrew Dreyfus

At the level the information is presented it sounds promising – that delivery systems might have more lattitude to use all of the tools available today to coordinate care (including patient access to their records online). The details are not listed, though. I wonder what about the plan would enable a more patient centered approach to implementing health information technology. Would a delivery system under this plan be spurred to promote personal health record adoption?

As we found when we visited Boston recently, adoption of relatively robust patient access systems has been less than desired, especially compared to systems where incentives are aligned. Maybe this might help?

I’m posting this as a trackback to the blog post to see if more information might be shared about this, either here or on the original blog. How does this new payment methodology stimulate patient access to health information technology and non-visit based care?


BCBSMA's desire to develop new way of paying for care is welcome news to our organization. At the risk of oversimplification, what is currently proposed is essentially capitation with quality incentives. For large, multispeciality groups like Harvard Vanguard, this type of payment has always tended to work well and is completely consistent with the type of care we've always delivered.

Genericly speaking, capitation arrangements do allow greater freedom for healthcare delivery organizations to innovate. However, there is yet to be any direct incentivation of innovative technologies to promote greater patient activation and participation in their health. Moreover, the incentives are still unidirectionally focused on physicians and not creatively paired with aligned incentives for insurer DM programs, employer health promtion programs, and even direct patient incentives.

Since we all know that true improvement in chronic conditions requires tremendous patient involvement for sustainable success, broader involvement of financial incentivization would do more to stimulate innovation in ways to better engage patients in their care.



Thanks for adding the health care provider perspective. It is good to hear that there is a trend toward greater alignment of incentives to support the right care at the right time and place.

Thanks again,


Ted Eytan, MD