Allina Health and Blue Cross and Blue Shield of Minnesota form value-based agreement
The agreement is expected to provide more stable and predictable revenue, a need underscored by the pandemic.
Allina Health and Blue Cross and Blue Shield of Minnesota have announced a six-year, value-based payment agreement that aims to reduce the cost of care by 10% over five years.
Blue Cross is Allina Health's largest payer and Allina Health is Blue Cross' largest provider of care for its Minnesota members. Collectively, the organizations serve a significant percentage of Minnesotans.
A hallmark of the agreement will be the sharing of data to inform care delivery and enhance the patient experience. It will foster more proactive and preventive care, and catalyze work to reduce the unacceptably high rates of health disparities across our community, Allina Health said.
The agreement will allow for the continued expansion of telehealth in a sustainable way.
WHY THIS MATTERS
The value-based agreement is designed to provide enhanced value for Blue Cross members while providing high-quality care and healthy outcomes.
This is being done by having additional preventive and coordinated care, maximizing the time available for doctor-patient relationships, streamlining the care delivery experience and simplifying administrative requirements.
The new agreement is expected to reduce costs. Currently, the portion of payments made by Blue Cross that are tied to achieving optimal patient outcomes are five to 10 times larger than what is outlined in typical outcomes-based risk arrangements.
By de-emphasizing the reliance on payments for each healthcare service delivered, providers can be protected from loss of revenue during periods of reduced volume – such as the recent pause on scheduled procedures during the pandemic, Allina Health said.
The pandemic underscores the importance of more stable and predictable revenue.
THE LARGER TREND
An increasingly popular alternative in healthcare contracts, value-based agreements can maintain revenue for a healthcare system, but with larger payment portions for optimal patient outcomes and quality of care.
Cleveland Clinic and Aetna recently announced the formation of an accountable care organization and launched a co-branded health insurance plan.
Allina Health and Blue Cross said they had been planning on the collaboration prior to the pandemic.
Allina Health performs more than 6 million patient visits per year, while approximately one in three residents in the state have coverage through Blue Cross. The agreement will impact the cost and quality of care for around 130,000 people.
ON THE RECORD
"COVID-19 accelerated the imperative that healthcare in the U.S. needs to be more coordinated, accessible and affordable for all who need care," said Dr. Penny Wheeler, president and chief executive officer at Allina Health. "The pandemic also unearthed significant gaps throughout the healthcare community that contribute to unacceptable health disparities. Through this agreement with Blue Cross, we will be better equipped to address health disparities and positively impact the future of health care in Minnesota."
"We've lived in a volume-based healthcare world where the profitability of sickness is greater than the profitability of wellness," said Dr. Craig Samitt, president and chief executive officer at Blue Cross and Blue Shield of Minnesota. "COVID-19 has hastened the need for change, and our value-based partnership with Allina Health is already proving to be a positive example of what's possible when healthcare plans and healthcare providers work collaboratively on shared challenges to improve the physical, mental and financial health of our patients and members."
Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com
