Caritas Christi Health Care chief executive Ralph de la Torre, MD, said the hospital chain is close to signing a payment deal with Blue Cross and Blue Shield of Massachusetts. The move to an "alternative quality contract" will boost payments to Caritas Christi from Blue Cross, and give it an opportunity to earn more than it could in a traditional contract based on annual payment increases. Blue Cross-Blue Shield's proposal involves a flat fee based on the number of patients treated, but caregivers can also earn bonuses by meeting quality targets.