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North Carolina Moving From Traditional Fee-For-Service Model to Payment Based on Health Outcomes

North Carolina is in the process of moving from the traditional fee-for-service model, in which doctors and hospitals are paid for each office visit, test or operation, to being paid based on health outcomes like controlling diabetes patients’ blood sugar or heart patients’ cholesterol, writes The New York Times. Blue Cross and the state are moving to contracts with doctors’ groups and hospitals that include cuts in reimbursement if quality outcomes fall short, typically after two years of incentive payments to expand physician services. This year, Blue Cross announced that it had signed five of the largest health systems in the state to contracts linking payments to total costs of care for their patient populations and quality measurements, not to hospital stays or surgical procedures.

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