Atrius Health and Blue Cross Blue Shield of Massachusetts have entered into a new seven-year agreement in which the two organizations will align around an advanced alternative payment model.
Atrius Health, which has 32 medical practices, with more than 50 specialties and 825 physicians in eastern and central Massachusetts, was one of the first providers to participate in Blue Cross’ Alternative Quality Contract (ACQ). Based on the success of the AQC, Blue Cross and Atrius Health are now collaborating to create new products and services for Atrius Health patients who are also Blue Cross members.
Focus areas will include developing more convenient ways of accessing care and navigating the healthcare system, more integrated population health programs, use of innovative technologies, and administrative simplification.
Atrius Health will receive a global budget for the care of more than 130,000 of its patients who are Blue Cross members with commercial PPO, HMO and Medicare plans. This is the first Blue Cross provider contract and first Atrius Health commercial payer contract to have full risk (cost and quality accountability) for PPO members. The agreement will allow Atrius Health to better invest in care delivery models to improve patient experience, slow health care cost growth and provide the right resources to help people stay healthy and out of the hospital or emergency department, the two organizations said.
"Blue Cross's commitment to improving patient experience makes them an outstanding partner for this journey toward a more accessible and affordable high-quality health care system in Massachusetts," said Steve Strongwater, M.D., president and CEO of nonprofit Atrius Health, in a prepared statement. "Their innovative approach to value-based payment goes hand in hand with our philosophy of finding new ways to better serve our patients, truly supporting our vision of transforming care to improve lives."
In a November 2018 interview with Healthcare Innovation’s Rajiv Leventhal, Strongwater described some of the reasons that Atrius has had success in the world of value-based payment. “We started as a staff model HMO, so we have been doing population health before it was described as population health. We have organized all of our care and systems around individual patients, and then populations of patients, meaning we have developed disease registries, and identified those people who sit in the high-risk categories—either the top 1 percent, 5 percent, or the rising risk categories,” he said. “Then have planned tailored interventions, including trying to manage and prevent [disease] for the general population. We have built most of this work around our Epic EHR [electronic health record], so there are a series of tools—be it order sets or reminders—that complements the analytics. And we have built the analytics into the EHR so it’s now analytics that are much more actionable.”
