ST. PAUL, Minn., Aug. 22, 2019 /PRNewswire/ -- Blue Cross and Blue Shield of Minnesota (Blue Cross) and Minnesota Oncology, a practice in The US Oncology Network, today announced a five-year agreement that will change the way cancer care is paid for and managed in order to deliver optimal health outcomes at lower costs.
This collaboration, which takes effect September 1, 2019, will make Blue Cross and Minnesota Oncology jointly accountable for the overall cost of cancer care provided to Blue Cross members through a value-based risk arrangement. The terms of the arrangement are based on the principle that effective outcomes for patients are determined by the quality of care provided – not the quantity.
"This transformation from a volume- to value-based payment model is driven by our shared goal of delivering the best possible outcomes at a lower cost to cancer patients, many of whom struggle to afford their care, even with insurance," said Craig Samitt, MD, MBA, president and CEO at Blue Cross. "We applaud Minnesota Oncology for stepping up to become part of the solution to the rising cost of healthcare in our state. I am confident this agreement will lead to a better care experience for the many Minnesotans impacted by this terrible disease each year."
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With an enhanced focus on patient-centric healthcare, clinical staff at Minnesota Oncology will offer care coordination services on an individualized basis for Blue Cross members. This approach will help to ensure that the comprehensive care model already in place consistently delivers the best possible outcomes by providing appropriate, medically necessary care at the right time and place.
The five-year collaboration will include an agreed-upon set of quality metrics based on the latest scientific research and proven clinical guidelines. Minnesota Oncology will be responsible for ensuring continued alignment with evidence-based best practices and, as a result, will no longer be required to secure prior authorization from Blue Cross for coverage of selected services that are typically associated with high rates of overutilization.
"Cancer patients face a big challenge, and we remain committed to providing comprehensive care including state-of-the-art therapies, precision medicine, genetic testing, palliative care and access to clinical trials," said John Schwerkoske, MD, president and medical oncologist at Minnesota Oncology. "We are very excited to collaborate with Blue Cross and Blue Shield of Minnesota to help make sure patients with cancer receive high-quality and high-value care in a community setting, close to home."