In 2009, Blue Cross Blue Shield of Massachusetts implemented a global budget-based payment system, the Alternative Quality Contract (AQC), in which provider groups assumed accountability for spending. We investigate the impact of global budgets on the utilization of prescription drugs and related expenditures. Our analyses indicate no statistically significant evidence that the AQC reduced the use of drugs. Although the impact may change over time, early evidence suggests that it is premature to conclude that global budget systems may reduce access to medications.
Pharmacology, Toxicology and Pharmaceutical Science
2
5%
Business, Management and Accounting
2
5%
Other
8
21%
Unknown
13
33%
Attention Score in Context
Attention Score in Context
This research output has an Altmetric Attention Score of 7. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 11 June 2025.
All research outputs
#6,768,459
of 34,361,833 outputs
Outputs from Inquiry: The Journal of Health Care Organization, Provision, and Financing
#250
of 911 outputs
Outputs of similar age
#75,068
of 421,552 outputs
Outputs of similar age from Inquiry: The Journal of Health Care Organization, Provision, and Financing
#4
of 4 outputs
Altmetric has tracked 34,361,833 research outputs across all sources so far. Compared to these this one has done well and is in the 79th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 911 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 16.2. This one has gotten more attention than average, scoring higher than 69% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 421,552 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 80% of its contemporaries.
We're also able to compare this research output to 4 others from the same source and published within six weeks on either side of this one.
