by Paige Minemyer | Nov 13, 2019 3:30pm
Blues plans are
launching a high-performance network nationwide.
The Blue Cross Blue
Shield Association (BCBSA) revealed this week that its member plans would offer
Blue HPN beginning in January 2021. The network will be available in 55 markets
across the U.S.
Jennifer Atkins, vice
president of network solutions at BCBSA, told FierceHealthcare that
the goal in launching the network was to build on the plans' existing
value-based and patient-centered models.
“As we pulled the plans together to work on
this national profile, we found we have a lot of commonalities in our existing
value-based arrangements,” Atkins said.
There was strong
interest in the individual markets for such a network, she said. About 70% of
members in BCBSA plans are enrolled in a value-based contract.
Employers are taking a more “activist”
role in healthcare, and part of that effort includes greater
uptake of options such as direct contracting and high-performance networks to
drive lower costs without pushing additional cost sharing for
employees.
Atkins said that
existing value-based contracts deliver an average of 10% in total cost savings
on top of savings in the Blue PPO, BlueCard, and that the BCBSA members expect
a high-performance network to grow that number further. With 74 million members
in its base, Atkins said the Blues plans believe they can reach the “critical
mass” necessary to gather quality providers.
In developing the
networks, the plans will take a “best of local” approach that allows each plan
to meet the needs of its markets under a shared set of standards. Quality
metrics focus on offering the appropriate care, promoting adherence and
boosting outcomes, and Blue HPN allows for individual plans to build in their
own metrics to fit regional needs.
“At the end of the
day, we’re looking for providers who are really focusing on the overall health
of the population and members, improving outcomes and being willing to take
steps along this journey with us,” Atkins said.
The experience for
members enrolled in Blue HPN is also highly local, Atkins said. The Blues
insurers will work closely with employers to ensure that communication
is clear and workers can understand what their plan entails.
A key concern in a
narrow-network plan is that members may not have a full grasp of what’s
covered, which could put them at greater risk of
unexpected medical bills that they cannot afford.
"We have been
working hard to ensure that when we’re communicating to employees though
employer that picked the high-performance network so that
they can be confident that they’re receiving the best care at best price,”
Atkins said.
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