In the latest blow to fee-for-service medicine, the nation’s Blue Cross and Blue Shield plans say they are spending more than $65 billion annually — about 20 percent of the medical claim dollars they pay — on “value-based” care that rewards better outcomes and keeps patients healthy.

The moves by the nation’s 37 Blue Cross and Blue Shield companies, a summation of which was announced today, are the latest push away from the traditional fee-for-service approach to medicine that can lead to overtreatment and unnecessary medical tests and procedures.

The Blue Cross Blue Shield Association, which is the trade group and lobby for Blue Cross plans, said its member plans have a portfolio of more than 350 “locally-developed, value-based programs in 49 states, Washington, D.C. and Puerto Rico.” These more accountable contracts are with more than 215,000 physicians, the association said.

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