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BCBSMA Adds Tufts Medicine to its Pay-For-Equity Payment Model

Analysis  |  By Jay Asser  
   May 24, 2023

The health plan said it is one of the first in the nation to introduce this type of value-based contract.

Blue Cross Blue Shield of Massachusetts (BCBSMA) is expanding its value-based efforts by bringing Tufts Medicine into its pay-for-equity financial payment model, the health plan announced.

As part of the contract, Tufts Medicine will focus on reducing inequities in colorectal cancer screenings, hypertension, diabetes care, and child and adolescent well-care visits.

"Across our system, we're doing everything we can to make health care more affordable, accessible and equitable," Tufts Medicine CEO Michael Dandorph said in the press release. "For more than a decade, we have aligned quality incentives within our contracts. Equity is one of our key quality metrics, so including this in our relationship with Blue Cross is a natural progression and will ensure continued superior outcomes for our patients."

BCBSMA said it is the first health plan in Massachusetts, as well as one of the first in the country, to use these contracts, which tie financial incentives to achieving measurable improvements in health equity.

Aside from Tufts Medicine, four other Massachusetts health systems have signed on to the value-based agreements: Beth Israel Lahey Health, Mass General Brigham, Steward Healthcare Network, and Boston Accountable Care Organization, which is part of Boston Medical Center.

BCBSMA stated 53% of its members now receive care from clinicians taking part in the pay-for-equity model.

"Resolving systemic inequities requires allyship, and it's our responsibility to work collectively with physicians and hospitals to improve health equity," said Sarah Iselin, Blue Cross' president and CEO. "By engaging another of our state's large health systems in these payment contracts, we're one step closer to a more affordable, equitable health care system for our members."

In the announcement, BCBSMA also highlighted its data on health equity for more than 1.2 million of its commercial Massachusetts members. The health plan said it is using the data, which reveals racial and ethnic inequities in areas of patient care, to work towards eliminating racial disparities in care.

Jay Asser is the contributing editor for strategy at HealthLeaders. 


KEY TAKEAWAYS

Tufts Medicine becomes the fifth health system to take part in Blue Cross Blue Shield of Massachusetts' equity-focused value-based agreement.

With the addition, the health plan stated that more than half of its members (53%) now receive care from clinicians involved in the payment model.


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