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HomeHealthcareBCBS Minnesota, Minnesota Oncology Obtain 10% Value Discount By way of Worth-based...

BCBS Minnesota, Minnesota Oncology Obtain 10% Value Discount By way of Worth-based Contract

After shifting away from a fee-for-service mannequin in 2019, Blue Cross and Blue Defend of Minnesota and Minnesota Oncology introduced final week that its value-based mannequin has achieved promising outcomes.

The five-year value-based settlement rewards Minnesota Oncology if the full value of look after BCBS Minnesota members with employer group protection is lower than rivals in Minneapolis and St. Paul. An evaluation of its most up-to-date accessible information discovered that the association achieved a complete value of care that’s 10% decrease than the Twin Cities’ oncology market. 

“That is the primary time we have now been in a position to reveal that high quality care will be inexpensive and if a supplier and payer work collectively, prices for most cancers care will be decreased,” stated Dr. Rajini Katipamula-Malisetti, vice chairman of medical oncology and high quality director of Minnesota Oncology.

Emergency visits and inpatient admissions additionally declined throughout this era for sufferers with BCBS Minnesota employer group protection. Minnesota Oncology declined to offer uncooked information, nevertheless.

A significant component for the lower in value, emergency visits and affected person admissions was the care coordination initiatives put in place with the value-based association. By way of the care coordination companies, Minnesota Oncology reaches out to BCBS Minnesota sufferers a number of occasions all through their most cancers journey.

“When they’re first recognized and are available to [Minnesota Oncology] for chemotherapy, our social staff, also called care coordinators, contact the affected person to debate any considerations they could have associated to remedy and unrelated to their remedy,” stated Jay Scott, director of managed look after the supplier. “The social work crew makes extra care coordination calls to sufferers later of their journey and a few sufferers keep in contact with the social staff all through their time at [Minnesota Oncology].”

After reaching these outcomes, BCBS Minnesota and Minnesota Oncology are increasing their settlement by including three new high quality measures in 2023, stated Eric Hoag, vice chairman of supplier relations for the payer, in a information launch. These measures are affected person reported ache enchancment, palliative care and social determinants of well being.

The preliminary information present that value-based care can each enhance outcomes and decrease prices, declared Dr. John Schwerkoske, president and medical oncologist at Minnesota Oncology.

“Most cancers sufferers face a giant problem on the subject of the price of high quality, complete care,” Schwerkoske stated in a press release. “Below this settlement with Blue Cross, we now have encouraging proof that our mannequin works. It’s attainable to supply state-of-the-art therapies, precision drugs, genetic testing, palliative care, and entry to scientific trials whereas decreasing total prices.”

Photograph: Nuthawut Somsuk, Getty Pictures



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