Pinterest tag

Allina, Blue Cross deal ties payments to outcomes, not procedures

[Business Journal, August 27, 2020] In a major shift in how a health insurer pays for medical services, Blue Cross and Blue Shield of Minnesota will start paying Allina Health System for patient outcomes instead of individual medical services.

"It's a big deal," Allina CEO Dr. Penny Wheeler said of the "value-based payment" agreement, announced Thursday. The agreement is expected to impact 130,000 people who have Blue Cross insurance and get care at Allina.

So what does "value-based care" mean? Dr. Craig Samitt, Blue Cross's CEO, used the example of a person with back pain. In a fee-for-service model, a hospital might steer that person towards surgery because that's one of the only solutions that insurance would cover. Under a value-based model, the insurance company would also cover more preventative treatments like acupuncture, which might be all that person needs to keep their pain under control.

Read the full story online (subscription required).

Share this article