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Value-based care networks are a promising opportunity for payers that want to manage costs and improve outcomes of beneficiaries. But effectively scaling collaborative, risk-based reimbursement networks for millions of beneficiaries requires a great deal of strategy and insight.
The BlueCross Blue Shield Association (BCBSA) has successfully scaled its value-based care initiatives through the Blue Distinction Total Care Network: a group of accountable care organizations (ACOs), patient-centered medical homes, and similar programs that operate in local BCBS payer markets.
In 2018, Total Care Network participants lowered costs by 35 percent, reduced beneficiary hospitalizations by 15 percent, and outperformed other providers in 22 out of 23 nationally-recognized quality measures.