Two large players in a small market are going to spend the next three years trying to collaborate with emerging incentives, as shared risk becomes the new normal.
Blue Cross & Blue Shield of Rhode Island has inked a three-year deal with the five-hospital Lifespan, the state's largest health system, that's being described as the most significant risk-sharing payer-provider contract in the state's history, covering about 35,0000 Medicare Advantage and commercially-insured patients.
While specific financial details of the contract aren't being disclosed, the two organizations say it's "the first step in moving away from the traditional fee-for-service model."
Working with 110 different primary care physicians -- about 40 percent of them from patient-centered medical homes and about 35 from Lifespan -- the partners will jointly invest in delivery redesigns that "reward physicians" for meeting certain quality and outcome goals.
It will offer a template for "physician-led, patient-centered, team-based" improvement, Peter Andruszkiewicz, president and CEO of Blue Cross & Blue Shield of Rhode Island, said in a media release.
"Our goal is for patients to receive the care they need and to realize better health outcomes at a lower cost," he added.
Timothy Babineau, MD, president and CEO of Lifespan, added that "our focus continues to be on enhancing the patient experience and finding the best and most appropriate ways to deliver health with care. This agreement allows us to take another step in this direction all while building on our relationship with the provider community and recognizing and rewarding quality care for our patients."
Blue Cross & Blue Shield of Rhode Island also recently set up the state's first multi-organization accountable care model with Care New England Health System and RI Primary Care Physicians Corporation.
Covering 10,000 Medicare Advantage members, the deal includes a pay-for-quality arrangement with RI Primary Care, an independent physicians association and Care New England's three hospitals and visiting nurses hospice services.