Christine McConville, Boston Herald, June 26, 2008

The country’s troubled health-care system can be repaired, Blue Cross Blue Shield of Massachusetts Chief Executive Cleve Killingsworth said yesterday, if patients, doctors and hospital administrators agree to fundamental changes in the way we pay for care.

“We have to change from process-based measures to outcome-based measures,” Killingsworth said at a lunchtime meeting with the Boston Herald’s editorial board.

The goal, he said, is to reward doctors whose patients get better and stay better. Health-care providers make more money now when they run more tests and use more elaborate equipment.

Killingsworth oversees the state’s largest insurer, with about 3 million members. He said hospitals are inputting patient data into an easily accessible database, and physicians are submitting patient prescriptions electronically.

Now, Americans need to revamp the way we pay for medical care, by rewarding high-quality instead of high-volume health care.

Herald editors asked Killingsworth about his $3.6 million annual compensation, which stunned members when it was reported earlier this year.

His pay had increased from $3 million in 2006, even though the firm’s net income during that same time dropped from $227.5 million to $209 million.

Blue Cross Executive Vice President Stephen R. Booma said even though the insurer is a nonprofit entity, its business peers are Fortune 500 companies. To attract and retain top professionals, the HMO has to pay competitive salaries, he said.

Killingsworth also said he had mixed feelings about Partners Health Care, a sprawling consortium of Massachusetts hospitals. On one level, he said, a large hospital network means a broader range of care for patients, and, because there are so many patients, top doctors want to be there, to treat rare diseases.

But he also said that he’s never seen a mega-hospital that lives up to its promise, because inefficiencies inevitably get in the way.

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