A GLIMMER OF HOPE? by Dolores Mitchell

For those of you who believe in that old French maxim, “the more things change, the more they remain the same”, some of the recent medical news stories may have shaken your cynicism. Whether it was Paul Levy at the Beth Israel Deaconess, publicly committing his institution to specific goals and promising to achieve safety measures putting that institution in the highest 2% ranking in the country, or Blue Cross announcing its willingness to stop paying fee-for-service claims to any providers who are willing to take a capitated fee (along with the chance of earning a hefty performance bonus), it sounds as though someone out there may be ready to do more than talk about the need for action to change our current dysfunctional medical system. I’m not surprised that Paul Levy is out front on tackling a tough issue, and I have confidence that he’ll get the BID to do everything in its power to make it happen. He has already solicited and received the public support of his board — a good first step — and announced his goals in public, a good second step. The next question is — which other hospitals will take up the challenge and join him? As for Blue Cross, although I’ve had my differences with them from time to time, they are state’s largest health plan, and they are in a unique position to start what Don Berwick refers to as the necessary “decoupling” of volume from value, and I wish them well on this offer. Again, the question is — which providers will take up the challenge and sign on? To use two old American maxims, “I’m not betting the family farm” on this, but I do “have my fingers crossed.”

Dolores L. Mitchell, Executive Director of the Group Insurance Commission of the Commonwealth of Massachusetts, the agency that provides life, health, disability and dental and vision services to over 285,000 State employees, retirees and their dependents.