Value-Based Care News

BCBSTX’s New Medical Centers Seek Multicultural Value-Based Care

The ten new centers plan to use an integrated care model and bilingual staff to deliver multicultural value-based care.

Value-based care, medical centers, BCBS, telehealth, integrated care

Source: Thinkstock

By Kelsey Waddill

- Blue Cross and Blue Shield of Texas (BCBSTX) opened the first of ten medical centers with Sanitas Medical Center (Sanitas), the payer announced last week, with an emphasis on their pursuit of multicultural, integrated, value-based care.

“To address the gaps and fragmentation in care that create barriers to good health, our goal with this collaboration is to provide value-based primary care to increase the opportunities for coordinated, high-quality health outcomes for our members,” Dan McCoy, MD, president of BCBSTX, said in a statement.

BCBSTX announced the partnership with Sanitas in April 2019. Construction began that spring. While the payer and health system still plan to officially launch the centers on January 1, 2020, they added that most of the centers will start accepting BCBSTX members and self-paying patients in the near future.

To serve Texas’s diverse population, the payer highlighted the centers’ multicultural, integrated, and value-based care model.

When it comes to delivering care across cultures, the literature is clear: communication is key to establishing trust with the patient. But cities like Dallas and Houston, which embrace large and diverse communities, can face language barriers that may cripple communication.

In such situations, lacking a personal connection with the physician can leave patients dissatisfied with their care experience. The inability to communicate can dissuade patients from trusting their providers, resulting in failure to adhere to their providers’ guidance and, ultimately, poorer health outcomes.

"Primary care physicians are the cornerstone of optimal healthcare outcomes,” McCoy emphasized. “They, in combination with their team of other healthcare professionals, help members and their families deal with the majority of their healthcare needs, navigate the healthcare system and coordinate care with the right specialists when care is needed outside a primary care setting.”

To accommodate Texas’s diversity, the centers’ medical staff will speak both Spanish and English. Furthermore, the centers will have on-site customer service representatives to bilingually answer questions about health insurance, Medicaid, and Medicare.

The centers have also enhanced their flexibility for patients’ schedules through longer open hours including on Saturdays and Sundays and, for most centers, 365 open days a year. The centers also hope to achieve greater flexibility for patients through a larger array of services and telehealth options.

The bilingual, on-site BCBSTX customer service representatives exemplify BCBSTX’s commitment to an integrated care model.

The medical centers will offer insurance guidance as well as a complete suite of healthcare services, intended to make the centers a “one-stop shop.” Their model incorporates advanced primary and urgent care, imaging services both for labs and diagnostics, coordinated care, wellness programs, and disease management services.

Retail clinics have popularized the one-stop shop model. CVS Health, for example, famously has incorporated the one-stop shop model with its Minute Clinics.

The retail clinic combats provider consolidation, America’s Health Insurance Plans (AHIP) recently hailed in a testimony to a Senate subcommittee.

Lastly, the ten centers will rally around value-based care. Sanitas regional medical director, Adriana Higuera, MD, underscored the centers’ focus on preventive care, wellness, and chronic disease management. Through coordinated care and streamlining the care process, the centers hope to ensure high quality care at low cost.

"The idea is to make flexible and affordable healthcare options more accessible for our members and their families,” McCoy explained. “We are optimistic that this collaboration will help advance value-based care, and in the process, have an impact on the cost of care for our members.”

Investments in value-based care models continue to surge among top payers like Cigna and UnitedHealth Group, as they cross off increased value-based payment models and heightening contributions toward social determinants of health. BCBSTX’s new medical centers represent another, more localized approach to tackling this industry-wide aspiration.