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After moving away from the fee-for-service model in 2019, Blue Cross and Blue Shield of Minnesota and Minnesota Oncology announced last week that its value-based model has achieved promising results.

The five-year value-based agreement rewards Minnesota Oncology if the total cost of care for BCBS Minnesota members with group employer coverage is lower than competitors in Minneapolis and St. Paul. An analysis of the most recently available data found the agreement achieved a total cost of care that was 10 percent lower than the Twin Cities oncology market.

“This is the first time we’ve been able to demonstrate that quality care can be affordable, and if a provider and payer work together, the cost of cancer care can be reduced,” said Dr. Rajini Kathipamulla-Malizetti, vice president of medical oncology and director of quality at Minnesota Oncology.

Emergency room visits and hospitalizations also decreased during this period for patients covered by the BCBS Minnesota employer group. However, Minnesota Oncology declined to provide raw data.

A major factor in reducing costs, emergency visits, and patient admissions was the care coordination initiatives introduced with the value-based arrangement. Through care coordination services, Minnesota Oncology connects with BCBS Minnesota patients multiple times throughout their cancer journey.

“When they’re first diagnosed and they come into their own [Minnesota Oncology] for chemotherapy, our social workers, also known as care coordinators, contact the patient to discuss any concerns they may have related to and unrelated to their treatment,” said Jay Scott, director of managed care for the provider . “The social work team make additional calls to coordinate patients’ care later in their journey and some patients stay in touch with social workers throughout their stay in [Minnesota Oncology].”

Following the achievement of these results, BCBS Minnesota and Minnesota Oncology are expanding their agreement by adding three new quality measures in 2023, Eric Hogue, the payer’s vice president of provider relations, said in a news release. These measures include patient-reported improvement in pain, palliative care, and social determinants of health.

Preliminary data show that value-based care can both improve outcomes and reduce costs, they said. Dr. John Schwerkoske, president and medical oncologist at Minnesota Oncology.

“Cancer patients face a major challenge when it comes to the cost of quality, comprehensive care,” Schwerkoske said in a statement. “Under this agreement with Blue Cross, we now have encouraging evidence that our model works. It is possible to offer cutting-edge therapies, precision medicine, genetic testing, palliative care and access to clinical trials while reducing overall costs.”

Photo: Nuthawut Somsuk, Getty Images

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