After transferring away from a fee-for-service mannequin in 2019, Blue Cross and Blue Protect of Minnesota and Minnesota Oncology introduced final week that its value-based mannequin has achieved promising outcomes.
The five-year value-based settlement rewards Minnesota Oncology if the overall value of take care of BCBS Minnesota members with employer group protection is lower than rivals in Minneapolis and St. Paul. An evaluation of its most up-to-date obtainable knowledge discovered that the association achieved a complete value of care that’s 10% decrease than the Twin Cities’ oncology market.
“That is the primary time we now have been capable of display that high quality care may be inexpensive and if a supplier and payer work collectively, prices for most cancers care may be decreased,” mentioned Dr. Rajini Katipamula-Malisetti, vice chairman of medical oncology and high quality director of Minnesota Oncology.
Emergency visits and inpatient admissions additionally declined throughout this era for sufferers with BCBS Minnesota employer group protection. Minnesota Oncology declined to offer uncooked knowledge, nevertheless.
A significant factor for the lower in value, emergency visits and affected person admissions was the care coordination initiatives put in place with the value-based association. Via the care coordination providers, Minnesota Oncology reaches out to BCBS Minnesota sufferers a number of instances all through their most cancers journey.
“When they’re first recognized and are available to [Minnesota Oncology] for chemotherapy, our social staff, also referred to as care coordinators, contact the affected person to debate any considerations they might have associated to therapy and unrelated to their therapy,” mentioned Jay Scott, director of managed take care of the supplier. “The social work staff makes further care coordination calls to sufferers later of their journey and a few sufferers keep in contact with the social staff all through their time at [Minnesota Oncology].”
After attaining these outcomes, BCBS Minnesota and Minnesota Oncology are increasing their settlement by including three new high quality measures in 2023, mentioned Eric Hoag, vice chairman of supplier relations for the payer, in a information launch. These measures are affected person reported ache enchancment, palliative care and social determinants of well being.
The preliminary knowledge present that value-based care can each enhance outcomes and decrease prices, declared Dr. John Schwerkoske, president and medical oncologist at Minnesota Oncology.
“Most cancers sufferers face a giant problem relating to the price of high quality, complete care,” Schwerkoske mentioned in an announcement. “Beneath this settlement with Blue Cross, we now have encouraging proof that our mannequin works. It’s potential to supply state-of-the-art therapies, precision medication, genetic testing, palliative care, and entry to medical trials whereas reducing general prices.”
Photograph: Nuthawut Somsuk, Getty Photos
