Transformational partnerships to improve the health of members while containing costs
Fargo, N.D. — Blue Cross Blue Shield of North Dakota (BCBSND) is partnering with North Dakota clinics and hospitals to launch Blue Alliance, a new approach of incenting participating clinics and hospitals with the goals of providing our members a better care experience, improving health outcomes and curbing rising costs at the same time. Blue Alliance is a value-based program that is built on four principles
- Members come first. The patient-centered medical home is the foundation of Blue Alliance where caregivers can focus on providing the right care, at the right time, at the right place and by the right health care provider.
- Deeper partnerships with providers. Through actionable health intelligence, BCBSND will use data for predictive analytics to help influence and inform care delivery to advance population health efforts.
- Pay providers for outcomes. Blue Alliance allows for the gradual transition from a fee-for-service contracting model to one that pays for quality of care and successful patient outcomes.
- Address key cost drivers. Blue Alliance provides information to help address key cost drivers to promote an affordable, sustainable health care system in the future.
Focused on members, Blue Alliance seeks to enable health care providers to practice through a patient-centered medical home model that builds an intentional relationship with a primary care provider. The partnership will allow BCBSND to analyze population health trends over time, which health providers can utilize to make more informed, proactive care decisions.
"BCBSND is strategically focused on collaborating with providers to transform how we pay for care," says Tim Huckle, BCBSND President and CEO. "A goal of the Blue Alliance partnership is to help curb escalating health care costs for a more sustainable, effective health care system in the future."
The program was designed in conjunction with BCBSND's Clinical Quality Committee comprised of nine independent North Dakota physicians who act as advisors. The Committee helped BCBSND establish quality metrics that will serve as the foundation for reimbursement under the program.
The Blue Alliance partnership provides a transformational framework for health care delivery that will focus on the quality of services versus the volume of services. Providers will be reimbursed for successful quality outcomes for BCBSND members. The Blue Alliance program also incents providers to transition practices to become more efficient and proactive, and BCBSND is providing data and support to help them in that transition.
Understanding that transformation takes time and providers are at different points in that transformation, Blue Alliance offers a three-level payment structure for varying levels of engagement.
"As health care spending continues to increase, the solution isn't simply to cut costs. It requires a complete paradigm shift in how we think about and approach health," says Dr. Lisa Faust, Sr. Medical Director of Behavioral Health for BCBSND.
"New and innovative payment and delivery systems, such as Patient Centered Medical Home, have been shown to improve the quality of care, reduce health disparities, reduce costs and improve patient and physician satisfaction," says Dr. Julie Blehm, Sr. Medical Director for BCBSND. "I believe Blue Alliance, our new value based program, is an example of a new innovative payment and delivery system that can achieve those goals."