ArticleHealth affairs (Project Hope)2015
The Early Impact Of The 'Alternative Quality Contract' On Mental Health Service Use And Spending In Massachusetts.
Article in Health affairs (Project Hope), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 3 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
25 citing papers in PubMed, 3 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
- Association of Alternative Payment and Delivery Models With Outcomes for Mental Health and Substance Use Disorders: A Systematic Review.JAMA network open · 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
- Prospective payment system transformation (2000-2024): temporal trends, payment architecture, and cross-national variation.Health economics review · 2026Review
- Behavioral responses of healthcare providers to prospective payment systems: a systematic review using the WHO framework (2000-2024).Health economics review · 2026Review
- Choice of high-deductible health plans among enrollees with a substance use disorder.Journal of substance use and addiction treatment · 2023Article
- Tacking upwind: reducing spending among high-risk commercially insured patients.The American journal of managed care · 2023Article
- The Future of Public Mental Health: Challenges and Opportunities.The Milbank quarterly · 2023Article
- Changes in spending and quality after ACO contract participation for dually eligible beneficiaries with mental illness.Healthcare (Amsterdam, Netherlands) · 2023Article
- High deductible health plans and spending among families with a substance use disorder.Drug and alcohol dependence · 2022Article
- The impact of HDHPs on service use and spending for substance use disorders.The American journal of managed care · 2022Article
- Innovations in Care Delivery for Patients With Serious Mental Illness Among Accountable Care Organizations.Psychiatric services (Washington, D.C.) · 2022Article
- Effects of High-Deductible Health Plans on Enrollees With Mental Health Conditions With and Without Substance Use Disorders.Psychiatric services (Washington, D.C.) · 2022Article
- Improving Physical Health Among People With Serious Mental Illness: The Role of the Specialty Mental Health Sector.Psychiatric services (Washington, D.C.) · 2021Article
- Taking account of accountable care.Health services research · 2021Article
- Electronic Health Information Exchange At Discharge From Inpatient Psychiatric Care In Acute Care Hospitals.Health affairs (Project Hope) · 2020Article
- Communicating about Mental Illness and Violence: Balancing Stigma and Increased Support for Services.Journal of health politics, policy and law · 2018Article
- Mental Health Spending and Intensity of Service Use Among Individuals With Diagnoses of Eating Disorders Following Federal Parity.Psychiatric services (Washington, D.C.) · 2018Article
- The Alternative Quality Contract: Impact on Service Use and Spending for Children With ADHD.Psychiatric services (Washington, D.C.) · 2017Article
- Medicare Accountable Care Organizations and Antidepressant Use by Patients With Depression.Psychiatric services (Washington, D.C.) · 2017Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
Accountable care using global payment with performance bonuses has shown promise in controlling spending growth and improving care. This study examined how an early model, the Alternative Quality Contract (AQC) established in 2009 by Blue Cross Blue Shield of Massachusetts (BCBSMA), has affected care for mental illness. We compared spending and use for enrollees in AQC organizations that did and did not accept financial risk for mental health with enrollees not participating in the contract. Compared with BCBSMA enrollees in organizations not participating in the AQC, we found that enrollees in participating organizations were slightly less likely to use mental health services and, among mental health services users, small declines were detected in total health care spending, but no change was found in mental health spending. The declines in probability of use of mental health services and in total health spending among mental health service users attributable to the AQC were concentrated among enrollees in organizations that accepted financial risk for behavioral health. Interviews with AQC organization leaders suggested that the contractual arrangements did not meaningfully affect mental health care delivery in the program's initial years, but organizations are now at varying stages of efforts to improve mental health integration.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.