Because health concerns vary from state to state, each Blue Cross Blue Shield plan develops value-based/quality care programs that address local needs. While BlueAlliance is the solution that addresses North Dakota concerns, it is part of a bigger, nationwide effort to improve health outcomes while containing costs.
The Blue Cross and Blue Shield Association works with independent Blues plans nationwide to tailor value-based plans appropriate to the population served by the specific plan.
Pay for performance
A pay-for-performance model rewards providers for meeting pre-established quality targets rather than paying based on the traditional fee-for-service model.
Patient-centered medical home (PCMH)
A patient-centered medical home model is flexible enough to meet the needs of the area it serves. Yet the PCMH foundation is always comprehensive primary care where a provider, patient and his/her family partner together.
Episode-based payments
Episode-based payments include a single price for all of the services needed by a patient for an entire episode of care. It creates pricing consistency for patients and payers.
Accountable Care Organizations
Accountable Care Organizations tie reimbursement to quality metrics and reduced costs for an assigned patient population. They become "accountable" to patients and payers for providing appropriate, efficient care.
