BCBS of Massachusetts adds Tufts Medicine to its value-based payment contracts
More than half of members in the state now receive care from providers participating in equity-focused payment contracts, Blue Cross says.
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Blue Cross Blue Shield of Massachusetts has added Tufts Medicine to its pay-for-equity financial payment model.
Blue Cross said it is the first health plan in Massachusetts -- and among the first in the nation -- to introduce contracts linking financial incentives to achieving measurable improvements in health equity.
As part of its agreement with Blue Cross, Tufts Medicine will focus on reducing inequities in colorectal cancer screenings, diabetes care, hypertension, and child and adolescent well-care visits.
Tufts Medicine CEO Michael Dandorph said, "For more than a decade, we have aligned quality incentives within our contracts. Equity is one of our key quality metrics, so including this in our relationship with Blue Cross is a natural progression and will ensure continued superior outcomes for our patients."
WHY THIS MATTERS
With the addition of Tufts, 53% of Blue Cross' Massachusetts members now receive care from clinicians taking part in these equity-focused value-based agreements, BCBS of Massachusetts said.
Tufts joins four of the state's other leading health systems which signed the agreements in December 2022: Steward Healthcare Network, Beth Israel Lahey Health, Mass General Brigham and Boston Accountable Care Organization, which is part of Boston Medical Center.
THE LARGER TREND
The Tufts Medicine Integrated Network is comprised of 2,300 primary care and specialist physicians and advanced practice clinicians, employed by Tufts Medicine or working in private practice.
Annual data of its 1.2 million commercial members has revealed racial and ethnic inequities in many areas of patient care, Blue Cross said.
Blue Cross said it has funded $25 million in Institute for Healthcare Improvement grants to support physician practices and hospitals with Alternative Quality Contracts in their efforts to eliminate racial and ethnic inequities in care.
In 2022, the health plan provided more than $13 million in funding and pro bono support to local not-for-profits focused on environmental justice, access to healthy food and addressing structural causes of health inequities.
ON THE RECORD
"Resolving systemic inequities requires allyship, and it's our responsibility to work collectively with physicians and hospitals to improve health equity," said Sarah Iselin, Blue Cross' president and CEO. "By engaging another of our state's large health systems in these payment contracts, we're one step closer to a more affordable, equitable healthcare system for our members."
Twitter: @SusanJMorse
Email the writer: SMorse@himss.org
