BCBS teams with Cityblock Health on primary care for Medicaid and MA members

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Five clinics serving Blue Cross and Blue Shield of North Carolina (Blue Cross NC) members are partnering with Cityblock Health, a healthcare provider for Medicaid and lower-income Medicare beneficiaries, in an effort to support Medicaid managed care in the state.

The Blue Cross NC clinics will tap into Cityblock's community-focused care model that focuses on a holistic approach to addressing physical and behavioral health, as well as social determinants of health.

The collaboration officially kicked off on July 1 for eligible members of Blue Cross NC's Standard Plan and Medicare Advantage in Charlotte, Greensboro, Winston-Salem, High Point and Fayetteville, and includes pediatric services and maternity support.

WHAT'S THE IMPACT

Cityblock's multidisciplinary care teams -- including primary care providers, behavioral health specialists, pharmacists, nurse care managers and others -- are led by Community Health Partners, who are typically hired from the communities they serve. They spend time getting to know each member, meeting them where and when works best for them, whether that's at one of the organization's hubs, at home, in the community or by phone, text message or video visit.

Community Health Partners work closely with each member on their personalized care plan and ensure they receive the care they need.

The clinics are currently open and Blue Cross NC and Cityblock have begun outreach to eligible members.

Cityblock partners with community-based organizations and health plans to deliver medical care, behavioral health and social services virtually, in the home and in their community-based clinics.

THE LARGER TREND

Low-spending Medicaid managed care plans result in reduced healthcare spending and utilization, decreased consumer satisfaction and increased avoidable hospitalizations, according to 2020 research from the National Bureau of Economic Research.

"In sum, there is no indication that low-spending plans achieve savings by promoting high-value care and achieving offsets or by targeting low-value care for elimination. Instead, similar to what happens when consumers face a high deductible, supply-side managed care tools appear to constrain virtually all types of care," researchers said in the report.

Researchers found that if an individual was enrolled in the lowest-spending plan, they would generate about 30% less in healthcare spending compared to being enrolled in the highest-spending plan.

Low-spending plans were found to reduce the utilization of high-value drugs like those used to treat diabetes, asthma and mental illnesses, as well as the use of high-value screenings for diabetes, cancer and sexually transmitted infections.

Beneficiaries enrolled in low-spending plans typically had decreased consumer satisfaction, according to the report. Results indicated that people were less likely to stay in lower-spending plans and were conversely more likely to stay in high-spending plans.
 

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Email the writer: jeff.lagasse@himssmedia.com