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Atrius Health, Blue Cross to Create Alternative Payment Model

The seven-year agreement will center around a higher quality, more affordable alternative payment model.

Atrius Health, Blue Cross create alternative payment model

Source: Thinkstock

By Jessica Kent

- Atrius Health and Blue Cross Blue Shield of Massachusetts have partnered to launch an advanced alternative payment model that will deliver a higher quality, more affordable healthcare experience.

In this new venture, the organizations will focus on developing more convenient ways of accessing care and navigating the healthcare system as well as more integrated population health programs, use of advanced technologies, and administrative simplification.

The agreement also aims to enhance alternative payment model innovation. 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.

“We’re excited to collaborate more deeply with Atrius Health to advance the goal of better care at a more affordable cost with an experience that helps patients better navigate the health system,” said Andrew Dreyfus, President and CEO of Blue Cross.

“It’s part of our strategy to enter into deeper partnerships with physicians and hospitals that are aligned with these goals.”

This is the first Blue Cross provider contract and first Atrius Health payer contract to have full risk, including cost and quality accountability, for PPO members. The partnership will help promote better alignment across the two organizations and enable Atrius Health to invest more in care delivery models that will improve the patient experience.

The partnership will build on the innovative work of both organizations, including Blue Cross’s Alternative Quality Contract (AQC), in which Atrius Health was one of the first providers to participate.

Since its launch a decade ago, this contract has shown considerable success. In February 2017, a study from Harvard Medical School found that disadvantaged patients receiving care under ACQ experienced a 1.2 percent higher rate of improvement on process measures than patients in more socioeconomically secure settings.

Based on the positive outcomes of ACQ, Blue Cross and Atrius Health are collaborating again to create an improved healthcare experience, as well as new products and services for Atrius Health patients who are also members of Blue Cross.

Atrius Health is also a participant in the Medicare Pioneer Accountable Care Organization Program, which has resulted in year-over-year financial improvements for the organization, as well as consistently high quality scores.

Both Blue Cross and Atrius Health expect that this agreement will enable them to expand innovative care models for other organizations. The two entities will take the advancements they make in this partnership and have these innovations serve as a model for how health plans and provider groups can improve quality, convenience, and affordability.

“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, MD, President & CEO of Atrius Health.

“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.”


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