Blue Cross Blue Shield of Massachusetts (BCBS Massachusetts) is expanding members’ access to primary care by adding Eden Health, On Belay Health Solutions and VillageMD to its network, the insurer announced Tuesday.
New York City-based Eden Health offers primary care, telemedicine and insurance navigation. On Belay Health Solutions, based in Boston, works with independent primary care physicians and helps them engage in value-based contracts. Chicago-based VillageMD is a primary care provider that is majority owned by Walgreens Boots Alliance.
These primary care physician groups will provide both virtual and in-person care for BCBS Massachusetts members.
“Research shows that patients who have an established primary care physician achieve better health outcomes than those who don’t,” said Dr. Ashley Yeats, vice president of medication operations at BCBS Massachusetts. “These additional physician groups each offer a wide-range of services — including care navigation support, chronic disease care, mental health support — both in-person and virtually, allowing members to access care where and when they need it.”
Eden Health, On Belay and VillageMD will all participate in the insurer’s value-based payment program. Through the program, clinicians are reimbursed based on the quality of care they provide, health outcomes and patient satisfaction.
“Clinicians that are part of the value-based payment program agree to take responsibility for the full continuum of care received by their patients, regardless of where the care is provided,” Yeats said. “By linking financial incentives to clinical quality, patient outcomes and overall resource use, the program is designed to moderate cost growth, while producing improvements in the quality of patient care.”
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
The news comes at a time when people in Massachusetts are experiencing challenges in accessing primary care services as demand increases and the workforce shrinks, according to The Boston Globe. Nationwide, more than 100 million Americans are struggling to receive primary care because of a shortage of providers, representing about a third of the country’s population, according to the National Association of Community Health Centers.
BCBS Massachusetts is aiming to fill this gap, Yeats said.
“Our goal is to ensure our members have access to a comprehensive primary care network and enable greater access to convenient, high-quality care,” Yeats stated. “We also want to engage as many physicians in these value-based contracts as we can to offer our members more primary care options and services.”
The insurer’s announcement follows its launch of the Virtual Care Team Feature, which allows members to receive primary care services through Carbon Health and Firefly Health.
Photo: Michail_Petrov-96, Getty Images
