Blue Cross Blue Shield of Massachusetts Will Incorporate Equity Measures into Payment Models

It's the first health plan in Massachusetts to announce such a plan, which will start in 2023.

Blue Cross Blue Shield of Massachusetts says it will incorporate equity measures into its contracts and payment programs with clinicians who care for Blue Cross members starting in 2023.

It's the first health plan in Massachusetts to announce such a proposal, which will integrate differences in the quality of care across racial and ethnic groups into its payment models.

"Our aim is to produce meaningful, measurable, and sustainable improvements in the equity of care. Payment is necessary but not sufficient to do this," Dr. Mark Friedberg, senior vice president for performance measurement & improvement at Blue Cross, said in a statement. "So, starting now, we are sharing data on inequities and engaging our provider network in collaborative efforts to address them."

In addition, new collaborative from Blue Cross and the Institute for Healthcare Improvement aims to help physicians and hospitals enrolled in the health plan's value-based payment model to prepare for equity-based financial incentives linked to improvements in racial inequities in care.

In related news, Blue Cross has also publicly shared results of a new analysis of racial and ethnic inequities in healthcare.

The company reviewed 2019 administrative and health data from more than 1.3 million Massachusetts that and identified racial disparities that, in many cases, represent lower-quality care for Black, Asian, and Hispanic members on 48 industry-standard measures that Blue Cross tracks as part of its ongoing quality assurance operations.

The analysis examined disparities across a range of categories for children and adults, including preventive and condition-specific care.

It found that:

• Asian, Black, and Hispanic members were less likely than white non-Hispanic members to receive screenings for colorectal cancer (67.0% for Asian, 63.8% for Black, 65.4% for Hispanic, vs 70.8% for non-Hispanic white members).
   
• Rates of severe maternal morbidity (life-threatening medical issues during childbirth) for Black commercial members were more than double that of white non-Hispanic members (2.8% vs 1.2%).
   
• Rates of adolescent well-care visits were lower for Black and Hispanic members than for white non-Hispanic members (68.9% for Black, 70.3% for Hispanic vs 80.2% for non-Hispanic white members).
   
• Black and Hispanic members were approximately 15-20% less likely than white non-Hispanic members to receive recommended antidepressant medication management.

Blue Cross has shared more detailed data with its clinical partners showing how their practices compare with others in terms of racial inequities in care. Blue Cross employer customers will have the option of receiving similar data for their employees.