Four Mass. hospitals sign onto anti-disparities payment model with Blue Cross

Beth Israel Lahey Health, Mass General Brigham, Steward and Boston Medical Center will now have financial incentives with Blue Cross to improve health equity.

Four Mass. hospitals sign onto anti-disparities payment model with Blue Cross

Zero health inequities on anything measurable. That's the mission of a new insurance-payment model from Blue Cross Blue Shield of Massachusetts -- one that will reward health systems that reduce racial and ethnic disparities in health care. But that's the goal,' Dr. Mark Friedberg, senior vice president of performance measurement and improvement at Blue Cross said. They will have pay-for-equity enforced starting on Jan. 1. "The terms of our partnership with Blue Cross fit squarely in our present operationalized intentionality of identifying inequities that create and perpetuate health disparities, with an explicit goal of closing gaps, and is powered by accountability and oversight.' This replaced the fee-for-service model, and instead bases payments on quality and value. In other words, providers are paid based on how well they serve patients. As a health plan, this is the most important tool we have to work toward a health system that provides affordable, quality and equitable care to all our members,' Andrew Dreyfus, CEO of Blue Cross, said in the release. This includes colorectal cancer screenings, blood pressure control and diabetes treatment. The health plan will add to this list as it evolves. Providers will get a larger payment if they achieve a higher equity score. Only four are involved in the pay-for-equity model because of the timing of their contract renewals. No group has said "no" to pay-for-equity at this stage, according to Friedberg. We really believe and hope that it will go well, and we'll start to see some improvements in equity of care over the coming years," Friedberg said. "But if that's not the case, Berkeley will report it anyway, and we'll be able to learn what we need to do differently in the future. I think that will help other payers and stakeholders learn from it.' Each contract is designed to reach unique needs of the hospitals. Point32Health agrees on equity benchmarks with these provider, and there are earnable dollars if they achieve those goals.