Health insurance payments to hospitals are usually a matter of extreme secrecy. Gus Mannochia with Blue Cross Blue Shield of Rhode Island can't even describe how the old payment program worked.

But he can talk about the new system- one which only increases hospital payments by the rate of inflation. To get more money, medical centers need to score well on a series of quality measures. Mannochia says it's a more transparent approach.

"One of the reasons for doing this is to be able to show to the people who buy insurance through blue cross that their investment is being well spent," he says.

Ninety percent of the state's hospitals have agreed to participate in the program this year. Blue Cross aims to have full participation by the end of 2012.

More details
Read about Blue Cross Blue Shield's quality standards here

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