- Minnesota hospital network Allina Health and Blue Cross Blue Shield of Minnesota have agreed to a multiyear, value-based pact intended to improve the care of patients and health plan enrollees and cut costs. Although the contract was in the works prior to the COVID-19 outbreak, both sides say the pandemic accelerated the need for more closely coordinated healthcare services.
- The provider and payer intend to cut the cost trend for care by 10% over the next five years. That will be achieved by focusing on services that fall under the value-based mantle. According to the two sides, the payments focused on improving patient outcomes will be five to 10 times larger than what is contained in a typical outcomes-based, risk-bearing agreement.
- Both Allina and the Minnesota Blues believe the agreement will improve the cost and quality of care for about 130,000 patients in total. Allina officials say the pact will prompt it to create more affordable sites for healthcare delivery and better address the societal factors that impact community health.
Value-based healthcare has seen increasing focus for the past decade, but it has mostly nibbled around the margins, creating some improvements in health for those with chronic illnesses, but often on a patchwork basis from community to community without a large sense of scale.
Meanwhile, there have been concerns that value-based care could be put on the back burner due to COVID-19, as providers hit hard financially focus on revving up revenue.
However, there have also been recent initiatives to boost value-based care, including a program announced by BlueCross BlueShield of North Carolina to support medical practices hit hard by COVID-19.
The Allina-Minnesota Blues agreement announced Thursday intends to push value-based dynamics further. Allina cares for 6 million patients in Minnesota every year. The Minnesota Blues has about 2.6 million enrollees, the large majority of whom live in the state. Such a pact among a payer and provider with huge geographic coverage — along with deeper commitments to improving care — could make a difference.
Under the terms of the agreement, telehealth services will be expanded by Allina to provide care quickly and more efficiently. Initiatives will also be created for controlling diabetes, providing statin therapy for patients with cardiovascular disease and for controlling blood pressure. The Minnesota Blues also agreed to remove administrative hurdles for obtaining care and make coverage more affordable. However, significant details of the pact have not yet been released.
"We've lived in a volume-based healthcare world where the profitability of sickness is greater than the profitability of wellness," Minnesota Blues CEO Craig Samitt said in a statement. "COVID-19 has hastened the need for change, and our value-based partnership with Allina Health is already proving to be a positive example of what's possible ... to improve the physical, mental and financial health of our patients and members."