ArticlePediatrics2014
Two-year impact of the alternative quality contract on pediatric health care quality and spending.
Article in Pediatrics, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Value-Based Provider Payment Initiatives Combining Global Payments With Explicit Quality Incentives: A Systematic Review.Medical care research and review : MCRR · 2020Pooled it
- Design and effects of outcome-based payment models in healthcare: a systematic review.The European journal of health economics : HEPAC : health economics in prevention and care · 2019Pooled it
- Trial
- Parent-identified opportunities for improving asthma care for children insured by Medicaid following implementation of statewide Medicaid Accountable Care Organizations in Massachusetts.Frontiers in allergy · 2025Article
- Medicaid Accountable Care Organizations and Disparities in Pediatric Asthma Care.JAMA pediatrics · 2024Article
- Specialist use among privately insured children with disabilities.Health services research · 2024Article
- A Comparison of Health Care Expenditures for Medicaid-Insured Children with Autism Spectrum Disorder and Asthma in an Expanding Accountable Care Organization.Journal of autism and developmental disorders · 2020Article
- Care Quality and Spending Among Commercially Insured Children With Disabilities.Academic pediatrics · 2019Article
- The Alternative Quality Contract: Impact on Service Use and Spending for Children With ADHD.Psychiatric services (Washington, D.C.) · 2017Article
- Socioeconomic Background and Commercial Health Plan Spending.Pediatrics · 2017Article
- Use of Low-Value Pediatric Services Among the Commercially Insured.Pediatrics · 2016Article
- Do Health Care Delivery System Reforms Improve Value? The Jury Is Still Out.Medical care · 2016Review
- Analysis of Healthcare Cost and Utilization in the First Two Years of the Medicare Shared Savings Program Using Big Data from the CMS Enclave.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2016Article
- What Can Canada Learn From Accountable Care Organizations: A Comparative Policy Analysis.International journal of integrated careArticle
- Primary Care Physicians' Experiences With and Attitudes Toward Pediatric Quality Reporting.Academic pediatricsArticle
- The impact of the global budget system on dynamics of dental manpower and utilization of dental services.Dental research journalArticle
- Clinical coordination in accountable care organizations: A qualitative study.Health care management reviewArticle
- The Effect of Network-Level Payment Models on Care Network Performance: A Scoping Review of the Empirical Literature.International journal of integrated careArticle
- Quality of Primary Care for Children With Disabilities Enrolled in Medicaid.Academic pediatricsArticle
- Difficulty Obtaining Behavioral Health Services for Children: A National Survey of Multiphysician Practices.Annals of family medicineArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
objectiveTo examine the 2-year effect of Blue Cross Blue Shield of Massachusetts' global budget arrangement, the Alternative Quality Contract (AQC), on pediatric quality and spending for children with special health care needs (CSHCN) and non-CSHCN.
methodsUsing a difference-in-differences approach, we compared quality and spending trends for 126,975 unique 0- to 21-year-olds receiving care from AQC groups with 415,331 propensity-matched patients receiving care from non-AQC groups; 23% of enrollees were CSHCN. We compared quality and spending pre (2006-2008) and post (2009-2010) AQC implementation, adjusting analyses for age, gender, health risk score, and secular trends. Pediatric outcome measures included 4 preventive and 2 acute care measures tied to pay-for-performance (P4P), 3 asthma and 2 attention-deficit/hyperactivity disorder quality measures not tied to P4P, and average total annual medical spending.
resultsDuring the first 2 years of the AQC, pediatric care quality tied to P4P increased by +1.8% for CSHCN (P < .001) and +1.2% for non-CSHCN (P < .001) for AQC versus non-AQC groups; quality measures not tied to P4P showed no significant changes. Average total annual medical spending was ~5 times greater for CSHCN than non-CSHCN; there was no significant impact of the AQC on spending trends for children.
conclusionsDuring the first 2 years of the contract, the AQC had a small but significant positive effect on pediatric preventive care quality tied to P4P; this effect was greater for CSHCN than non-CSHCN. However, it did not significantly influence (positively or negatively) CSHCN measures not tied to P4P or affect per capita spending for either group.
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Registered trials
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