Despite medical groups' clear apprehension about new payment models that put more financial risk on practices, Massachusetts' existing version of a global payment system is winning over its share of fans.

Dr. David Pickul, medical director of the Lowell General Physician Hospital Organization, and Dr. Philip Gaziano, president and CEO of Accountable Care Associates in Springfield, are among those who attest that some careful shifting of risk represents change for the better.

"Unlike so-called capitation plans of the past, it's not a matter of an insurer saying, ‘We're putting you on a budget with less money than before, so you'd better figure out how to do less,'" they wrote in a recent post for WBUR's CommonHealth blog. "Instead, a well-designed global payment program offers doctors and hospitals assurance that if they provide ever-higher standards of care while reducing waste and inefficiency, they will have the time and money they need to deliver better outcomes for their patients and invest in the people, systems, and technology required to continuously improve the way they practice."

Richard Tolstrup, the Northeast Hospital Corporation's director of physician recruitment, concurs in that his Physician Hospital Organization has succeeded in providing exceptional care and outcomes at lower costs through its participation in Blue Cross Blue Shield's alternative quality contract. At Beverly Hospital, for example, physicians' employment agreements now tie compensation to roughly 30 patient quality measures, as well as patient satisfaction scores. Physicians receive bonuses if they meet or exceed their targets in both areas, Tolstrup explained, and they lose some compensation if they fall short.

"The amount of money each physician has at risk isn't earth shaking, but it is enough to capture their attention," he wrote, adding that most physicians would stand to earn bonuses.

To learn more:
- read the CommonHealth post
- see this article from the Association of Staff Physician Recruiters

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