Allina Health and Blue Cross Blue Shield of Minnesota struck a six-year value-based contract. Between the large, Minneapolis-based health system and the insurer, the agreement is expected to affect roughly 130,000 people.
The two entities had been planning a value-based care agreement several months before the start of the Covid-19 pandemic. But the health crisis has made it that much more timely, with a business model that would lead to more reliable payments as several health systems have seen a significant dip in patient volumes. According to a recent report by Kaufman Hall, adjusted hospital discharges were down 13% compared to last year.
Market Trends to Watch for Health Systems and Their Specialty Pharmacies
The future looks bright for the integrated specialty pharmacy model – for health systems, providers, and most importantly, for patients.
“COVID-19 accelerated the imperative that health care in the U.S. needs to be more coordinated, accessible and affordable for all who need care,” Allina Health CEO Dr. Penny Wheeler said in a news release. “The pandemic also unearthed significant gaps throughout the health care 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.”
The goal is to reduce the cost trend for Blue Cross members who seek care at Allina Health by 10% over five years. BCBS of Minnesota claims that it is paying 5 to 10 times more than in typical risk-based agreements.
“Allina Health is putting a significant amount of their profit margin at risk, while Blue Cross is providing a significant amount of population health payment upfront,” an Allina Health spokeswoman wrote in an email. “That investment will enable Allina Health to build the infrastructure needed to implement new programs, as well as support existing care models that don’t currently have a revenue source that would not be otherwise funded in a fee-for-service or low-risk value-based reimbursement model.”
The plan will be structured to reward preventive care, such as diabetes A1c control and statin therapy for patients with cardiovascular disease.
Reducing Clinical and Staff Burnout with AI Automation
As technology advances, AI-powered tools will increasingly reduce the administrative burdens on healthcare providers.
Allina Health also said it would use the agreement to expand its care coordination and offer more affordable sites for care. Expanded telehealth services, which were broadened after the start of the Covid-19 pandemic, are also part of the agreement.
Photo credit: mediaphotos, Getty Images