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With complex proposals like these - which involve wide-ranging plans from tramline extensions, fast-transit bus routes, new bus "quality contracts", cycle provisions, school buses and much more, not to mention a peak-time, "cordon-model" congestion charge – there's a lot to debate and many questions to be asked.
The latest independent evaluation of the Blue Cross program, published online by the journal Health Affairs in July, showed that groups covered by alternative quality contracts spent 1.9 percent less on average on medical care than similar Blue Cross groups without such contracts in the first year and 3.3 percent less in the second year.
Under the Blue Cross approach, groups of doctors and hospitals (the vast majority were previously paid on a fee-for-service basis) have chosen to enter "alternative quality contracts," which pay them a negotiated total sum to provide all the care their Blue Cross patients will need over the course of a year.
Table 8 Second round Delphi panel on the trust and quality contracts Delphi Panel Added Statements on the trust and quality contracts Agreement Level Achieved Consensus?
One North East Labour MP believes quality contracts could tackle that.
Chairman Kevin Carr said: "The quality contracts are going to be very very expensive.
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And this is in an area where the combined authority is actively pursuing proposals for a quality contract scheme.
In Massachusetts, Blue Cross Blue Shield has created an "alternative quality contract" that gives hospitals a fixed budget for a patient, with additional rewards for improving the quality of care.
"I recognise that Nexus have the right to bring in a quality contract, but it's not going to improve the lot of passengers.
After hearings this year, the Quality Contract Scheme board chaired by the traffic commissioner for the north-east said Tyne and Wear's proposals to control bus routes, timetables and fares would improve services, but would not provide value for money.
Indeed, doctors providing care to about 77 percent of Blue Cross Blue Shield of Massachusetts members have signed on to such "alternative quality contract" agreements, giving them an incentive to prevent readmissions, cut out unnecessary procedures and otherwise reduce spending.
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