Boston Children’s Hospital Joins Blue Cross Blue Shield of Massachusetts’ Health Equity Payment Program

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Patients at the Boston Children’s Hospital will now have access to value-based care payment plans through the Blue Cross Blue Shield of Massachusetts.¹ While the hospital is the first children’s hospital to participate in the program, it is joining five of the state’s health systems that are already in the program. This move is part of a larger movement within the healthcare industry to incorporate payment plans based on value-based care.

Value-based contracts are based on achieving certain goals that improve the patient’s health equity. Proponents of these plans believe that they are a possible solution to rising healthcare costs in US. They also believe that these plans make payers more likely to approve more complex treatment options. Payers are provided with financial incentives for achieving these goals through Blue Cross Blue Shield’s program.

The other healthcare organizations participating in the program are Tufts Medicine, Steward Healthcare Network, Beth Israel Lahey Health, Mass General Brigham, and Boston Accountable Care Organization Inc.

In a press release, Blue Cross president and CEO Sarah Iselin said, “Our kids are literally our future and yet we know that racial and ethnic inequities in health care jeopardize that future in so many ways. We are so fortunate to be working with the experts at Boston Children's who understand how to close those gaps and address the challenges unique to kids and families with the goal of ensuring that everyone has access to the care and support they need and deserve."

In the same press release, Boston Children’s Hospital president and CEO Kevin B. Churchwell, MD, said, “Health equity for all families is at the forefront of our goals here at Boston Children's, so this was a natural move for us. This partnership with Blue Cross marks a significant milestone in eliminating inequities in healthcare, and we look forward to continuing our work together in this space."

"We're working collaboratively with provider organizations to advance and improve health equity," said Dr. Mark Friedberg, senior vice president of performance measurement & improvement at Blue Cross. "Engaging another large Massachusetts health system—especially one focused on children's care—is an important step toward making measurable improvements in health care equity."

The cost of healthcare is a key issue for many people.

In March of this year, Blue Cross Blue Shield of Massachusetts announced the results of a survey conducted by Beacon Research.² According to the results, residents of the state consider the cost of healthcare to be one of their top concerns. The costs associated with co-pays and bills were also a major concern for the majority of respondents.

Most alarmingly, many residents stated that they had put off healthcare due to concerns over the costs.

In a press release issued at the time, Iselin said, “These findings underscore what we know and hear from our members on a regular basis. Residents are struggling with health care costs, causing them to put off care and make tough decisions. This is deeply concerning in a state committed to health care access and, without action, could lead to health implications statewide. This poll underscores the urgent need for our health care community to work together on managing costs and ensuring affordable options for residents, businesses, and state government."

Beacon Research founder and president Chris Anderson said, “These results show that consumers are deeply concerned about the costs of health care. This poll provides a real time snapshot of how prices are impacting their decisions on whether to access care and what consumers are experiencing in our health care system statewide."

Sources

1. Boston Children’s Hospital Joins Blue Cross Blue Shield of Massachusetts’ Groundbreaking Payment Program Focused on Improving Health Equity. Blue Cross Blue Shield of Massachusetts. April 30, 2024. Accessed May 1, 2024. https://www.prnewswire.com/news-releases/boston-childrens-hospital-joins-blue-cross-blue-shield-of-massachusetts-groundbreaking-payment-program-focused-on-improving-health-equity-302130886.html
2. Massachusetts Residents Cite High Costs as the Most Important Issue in Health Care. Blue Cross Blue Shield of Massachusetts. March 20, 2024. Accessed May 1, 2024. https://www.prnewswire.com/news-releases/massachusetts-residents-cite-high-costs-as-the-most-important-issue-in-health-care-302093523.html