On September 16, 2020, two of the largest not-for-profit healthcare entities in the mid-Atlantic region – CareFirst BlueCross BlueShield (CareFirst), a healthcare insurance company, and MedStar Health (MedStar), a healthcare provider – announced their plan to work together to offer value-based health care in an effort to improve affordability, accessibility, quality, and patient experience for the communities they serve.
This new value-based care partnership will focus on positive patient outcomes and value for the services delivered, instead of a more traditional payment approach, which tend to be linked solely to the volume of patient visits. With an emphasis on preventive care, CareFirst and MedStar estimate this value-based partnership will deliver improved health outcomes and quality of care for patients and positively impact the projected costs of care during the next seven years by a cost savings of roughly $400 million.
The partnership will be led by a management team jointly staffed by CareFirst and MedStar which will focus on:
- Improved patient experience in health care;
- Care coordination, including collaboration between primary care physicians and specialists;
- More personalized care for patients;
- Additional and/or more focused support for patients with the greatest healthcare needs;
- Identifying services where more capacity is needed to support populations in particular geographic areas; and
- Enhanced technology integration, including clinical data sharing.
Through this partnership, CareFirst and MedStar will be addressing disparities that may have long-existed but have been brought to light by the COVID-19 pandemic. The partnership will aim to develop an understanding of what the barriers are to health, care, follow-up, and experience as well as continually work with others to remove barriers so that the patients served by both organizations can live their healthiest lives.
It’s also likely that virtual care and telehealth will be an important component of the value-based partnership going forward. “Home health care will be an important part of how we improve the health of our patients in the years ahead,” Kenneth A. Samet, President and CEO of MedStar Health, said. “The ability to take advantage of new technologies and telehealth, combined with a physical care visit by a home care nurse when appropriate, will help us improve access and continuity for patients with both chronic and immediate needs.”
MedStar and CareFirst Reactions
“We applaud MedStar for their leadership in joining with us to help solve one of the most complex problems in the United States economy – helping to reduce the rate of escalations in healthcare costs, which impact governments, employers and families,” said CareFirst President and CEO, Brian D. Pieninck. “As two not-for-profit healthcare companies spanning the same region and serving the same people, we have a shared responsibility to ensure members and employers are getting maximum value for their healthcare dollar. Through this unique partnership, we will help to transform the healthcare landscape to deliver on our shared missions to increase access to quality, affordable care.”
“This partnership between MedStar Health and CareFirst allows for creativity, innovation and unprecedented collaboration between our two organizations to help transform health care,” said Kenneth A. Samet. “Working together to remove barriers and solve challenges will provide our patients with more convenient access to manage their health and experience better outcomes, while helping to make care more affordable. This important new partnership will benefit the communities we already serve together.”