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Cleve Killingsworth speaking at The King's Fund Annual Conference

Cleve Killingsworth, Chairman and CEO, Blue Cross and Blue Shield of Massachusetts Inc, USA, speaking at The King's Fund Annual Conference, held on 24 November 2009.

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Cleve Killingsworth speaking at The King's Fund Annual Conference

  1. 1. The King’s Fund Cleve L. Killingsworth Chairman & Chief Executive Officer November 24, 2009
  2. 2. Key Components of the Alternative Quality Contract INITIAL GLOBAL PAYMENT LEVEL Year 2 Year 1 Year 3 Year 4 Year 5 <ul><li>Providers receive a global payment - based on their current contract - to cover all services. </li></ul><ul><li>Payment is health-status adjusted </li></ul><ul><li>Inflation factor derived from the Consumer Price Index (Yellow) </li></ul>Inflation - CPI
  3. 3. Key Components of the Alternative Quality Contract <ul><li>Offers providers incentives on top of their global payment which can increase their total payment by up to 10% . (Green) </li></ul><ul><li>Benchmarks designed to acknowledge current performance and reward quality improvement </li></ul>INITIAL GLOBAL PAYMENT LEVEL Year 2 Year 1 Year 3 Year 4 Year 5 Inflation - CPI Performance
  4. 4. Key Components of the Alternative Quality Contract INITIAL GLOBAL PAYMENT LEVEL Year 2 Year 1 Year 3 Year 4 Year 5 <ul><li>Providers have opportunity to achieve additional margin (dark blue) by reducing overuse and misuse of procedures such as: </li></ul><ul><ul><li>Knee, Hip and Back surgery </li></ul></ul><ul><ul><li>Hysterectomy </li></ul></ul><ul><ul><li>Non-emergent use of Emergency Departments </li></ul></ul>Inflation - CPI Performance Savings Opportunity
  5. 5. The King’s Fund Cleve L. Killingsworth Chairman & Chief Executive Officer November 24, 2009

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