Dec 15, 2022
A bold step to address health inequities
The challenge is profound – by many measures, Americans of color receive lower-quality health care than their white peers – and addressing it requires bold action.
Today, Blue Cross Blue Shield of Massachusetts announced it is taking its most significant step to ensure high-value, high-quality, equitable care for its 2.9 million members and beyond.
The state’s largest health plan is the first to create payment contracts that reward Massachusetts clinicians for eliminating racial and ethnic inequities in care.
Four of the state’s largest health care systems have signed the Blue Cross agreements, which link financial incentives to improvements in health equity: Steward Healthcare Network, Beth Israel Lahey Health, Mass General Brigham Health and Boston Accountable Care Organization, Inc. Together, these systems provide care to nearly 500,000 Blue Cross members.
And the effort has the potential to affect many more patients.
The next evolution in improving care
This initiative builds on the innovative Alternative Quality Contract Blue Cross launched more than a decade ago, which rewards clinicians’ efforts to improve the quality of the care they deliver, a model that researchers have found effective.
As a health plan, this is the most important tool we have to work toward a health system that provides affordable, quality and equitable care to all our members
said Andrew Dreyfus, CEO of Blue Cross.
The new contracts initially will focus on measuring and rewarding equity in care in several clinical areas where inequities have been identified, including colorectal cancer screenings, blood pressure control and care for diabetes. Additional categories will be added as the payment model evolves.
“This encourages health care systems to increase their investments in developing, expanding and sustaining programs that produce measurable improvements in equity,” said Dr. Mark Friedberg, senior vice president, performance measurement and improvement at Blue Cross.
This is a major step for truly integrating equity into quality efforts. Practical lessons will emerge on what it takes for providers and payers to collaborate on eliminating disparities in the healthcare ecosystem.
said Dr. Laurie Zephyrin, a physician who is senior vice president for advancing health equity, The Commonwealth Fund.
Perspectives from clinicians
Steward, the largest physician-owned private for-profit health care network in the United States, will address racial disparities in colorectal cancer screenings and high blood pressure treatment under its new contract.
“We are proud to sign onto an agreement that marks an important step forward towards providing equitable care to patients,” said Dr. Joseph Weinstein, Steward Health Care Network’s chief physician executive. “Our clinicians are working diligently to break down barriers to health equity, and this partnership is a powerful tool in our mission to ensure we continue to deliver high-quality care at a sustainable cost.”
BACO’s primary care sites have more than 111,000 members, many living in underserved parts of the Commonwealth. As part of the agreement with Blue Cross, they too will focus their efforts on colorectal cancer screenings and controlling high blood pressure.
“I have believed for a long time that financial investment in discovering and disrupting inequity barriers is a sure win-win business model that renders a return. I’m proud of Blue Cross for taking a bold step in this direction,"
said Dr. Thea James, vice president of mission and associate chief medical officer at Boston Medical Center.
More than 1 million people rely on care from BILH clinicians. Through its agreement with Blue Cross, BILH is addressing racial disparities in comprehensive diabetes care and controlling high blood pressure.
“We’re pleased to be working with Blue Cross on transforming value-based care to address deeply rooted health inequities,” said Juan Fernando Lopera, chief diversity, equity and inclusion officer at Beth Israel Lahey Health.
Mass General Brigham, the largest health system in the state, is an integrated academic health care system that offers a full continuum of care.
“This health equity partnership with Blue Cross is aligned with our organizational mission to eliminate racism and builds upon our investments within our own system and the communities we serve,” said Niyum Gandhi, chief financial officer and treasurer at Mass General Brigham. “We are proud to join Blue Cross and other local health systems to ensure that equity is at the heart of patient care strategy.”
A continuing commitment
Through this groundbreaking effort, Blue Cross is continuing its commitment to tackling health inequities.
Last year, the health plan began publishing data for more than 1.2 million of its commercial Massachusetts members, which revealed racial and ethnic inequities in many areas of patient care. The company gives shares comprehensive data on health disparities with value-based health systems, and has created a collaborative learning community to develop and test solutions.
Blue Cross also funded $25 million in Institute for Healthcare Improvement grants for 13 of the state’s largest provider organizations, including the four that have signed new contracts.
The insurer will seek to sign value-based contracts with equity provisions with other Massachusetts health systems in the months and years ahead.
While these systems are among the first to take part in these payment contracts, we’re eager to add additional health care organizations in Massachusetts. Our goal is to engage as many physicians and hospitals in equity improvement as we can.
said Sarah Iselin, Blue Cross’ CEO-elect.