BCBS Massachusetts Forms Value-based Contracts to Advance ...

BCBS Massachusetts Forms Value-based Contracts to Advance ... unknown

Blue Cross Blue Shield of Massachusetts has entered into value-based payment contracts focused on improving health equity with four healthcare organizations, the payer announced Thursday.

The contracts are with Steward Health Care Network, Beth Israel Lahey Health, Mass General Brigham and Boston Accountable Care Organization, which is part of Boston Medical Center. In total, these organizations care for more than 550,000 members of BCBS Massachusetts. Each organization will be working on select health equity measures.

BCBS Massachusetts believes it is the first health plan in the country to be offering this type of program, claimed Dr. Mark Friedberg, senior vice president of performance measurement and improvement of the insurer.

“Our goal is to eliminate inequities in the care our members receive and to help create a more equitable, affordable health care system,” Friedberg wrote in an email. “We want to engage as many physicians and hospitals in equity improvement as we can.”

All four organizations will be initially focused on reducing disparities in controlling high blood pressure. Steward Health Care Network and Boston Accountable Care Organization will also focus on colorectal cancer screenings and Beth Israel Lahey will address comprehensive diabetes care. These measures were chosen because they had “sufficient equity gaps” among large populations across multiple races and ethnicities, Friedberg said. As the program evolves, additional health equity measures will be added.

“We can incentivize and enable improvements by tying payments to equity measures … Each provider organization will receive greater payments as inequities among the patients they serve get smaller,” Friedberg said.

To track the success of BCBS Massachusetts’ health equity efforts, the Center for Healthcare Organization and Innovation Research at the UC Berkeley School of Public Health will be conducting an independent external evaluation of the insurer. In August, the Commonwealth Fund awarded the research organization a more than $397,000 grant to study BCBS Massachusetts’ work in health equity.

In 2021, BCBS Massachusetts began collecting data on racial disparities in healthcare among its members and clinical partners. This data showed areas of significant inequities, which led to the creation of these value-based contracts, Friedman said.

While the payer is initially starting with these four healthcare organizations, it hopes to enter into value-based contracts for health equity with others in the future.

“While Steward Health Care Network, Beth Israel Lahey Health, Boston Accountable Care Organization, and Mass General Brigham are among the first to take part in these payment contracts, we’re ready and eager to add additional health care organizations,” Friedman said.

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