Blue Cross Blue Shield of Massachusetts announced that it’s contracting with three new provider groups partly in an effort to offset the primary care physician shortage.
BCBSMA has expanded its network to include Eden Health, On Belay Health Solutions and VillageMD, which puts the number of PCPs in the insurer’s network to over 7,000. Lisa Glenn, BCBSMA vice president of network partnerships and innovation, said in a press release that the expansion represents the latest move by the health plan to provide primary care in a more consumer-focused way.
“At a time when it’s hard to schedule an appointment with a primary care provider, we’re working hard to give our members more options and enable greater access to convenient, high-quality care,” Glenn said.
The groups will be participating in BCBSMA’s value-based payment program and will rely heavily on virtual health to address the needs of patients even as the number of PCPs in Massachusetts and throughout the U.S. continues to dwindle.
Matt McCambridge, CEO and co-founder of Eden Health, said in a press release that “we believe all patients deserve access to trusted health care and the combination of virtual and in-person care delivers a uniquely impactful health care experience. Preventative care—supported by proactive care planning and long-term relationships with trusted care providers—is the type of health care that we need.”
Among other services, the three physician practices will offer chronic disease care, mental health aid and care navigation support, according to BCBSMA. Patients of the three new provider groups will have access to MyBlue, the BCBSMA network that officials said offers treatment options and other data about a member’s health.
"Value-based care models enable primary care providers to play a more proactive role in overall patient care, improving health outcomes and creating better patient experiences," Andrew Allison, co-founder and CEO of On Belay Health Solutions, said in the press release. "Together, we can better ensure patients get the timely, robust care they need across their entire health care journey.”
Ashley Yeats, M.D., BCBSMA’s vice president of medical operations, told Fierce Healthcare in an email that these provider groups were all founded within the last decade and have varying degrees of experience in other markets. BCBSMA is the first Massachusetts-based health plan Eden Health is working with.
And while VillageMD has been part of BCBSMA network since December 2021, it recently agreed to further collaborate on efforts to improve timely access to primary care.
“Telehealth can ease administrative barriers, help clinicians see more patients and reduce overall costs. All three of these physician groups offer access to both in-person and virtual care for our members," Yeats said. "For example, Eden Health is a virtual-first provider that allows their patients to connect to their health care provider not only in-person if desired, but also via text, phone, or secure video all through the convenience of their app.”
The expansion of the BCBSMA network represents the latest move by the insurer to shore up and improve primary care. Last year, the health plan inked a deal with four large health systems that cover more than half a million individuals that rewards provider efforts to eliminate racial and ethnic inequities in healthcare.
The number of medical school students who want to go into primary care has been shrinking for years. A report by the Robert Graham Center in February noted that just a fifth of all physicians who completed their residency were practicing primary care two years later.
“Overall, about 1 in 3 U.S. practicing physicians are PCPs, so the data point to a national need to strengthen the PCP pipeline to prevent the shortage from worsening,” the report stated.
A report in March by FAIR Health, a not-for-profit organization that seeks to enhance price transparency in healthcare, found that a large number of individuals receive their primary care from non-physicians, especially in rural areas. However, the report also found that Massachusetts ranked No. 1 in terms of having the lowest percentage of residents who had not seen a primary care provider between 2016 and 2022. Sixteen percent of Massachusetts residents were in that category, followed by New Mexico (20.1%) and Wisconsin (20.3%).