Point32Health has partnered with Cortica, an autism care provider, to expand access to neurological therapies in Massachusetts.
The payer is the parent company of Harvard Pilgrim Health Care and Tufts Health Plan, which merged in 2021. Tufts Health Plan members will have access to the services beginning in September, while MassHealth and Harvard Pilgrim members will starting later this fall.
“Not only will this improve access to much needed treatment for our commercial and Medicaid members, it will help our members better navigate the healthcare system while receiving the quality of care they deserve,” Jill Borrelli, vice president of behavioral health at Point32Health, said in a press release. There are 875,000 commercial and Medicaid Point32Health members in Massachusetts, the organization told Fierce Healthcare.
Since its merger, Point32Health has been working to integrate behavioral health care and has sought partners like Cortica to meaningfully do so. “People’s heads and bodies are attached, and it doesn't make sense to think about that as two separate tracks,” Borrelli told Fierce Healthcare.
Cortica offers an integrated care model with medical care, applied behavioral analysis, developmental therapy and family support for patients with neurological and developmental disorders and specializes in autism care. It hopes to revolutionize a historically fragmented healthcare system in which caregivers see different specialists for neurological and medical comorbidity diagnoses. While patients with resources can afford to get help sooner, many patients of lower socioeconomic status cannot. Yet early intervention is key for children on the spectrum, the companies say.
The provider, which has a hybrid model, will set up four in-person centers over the next six months in the state, executives told Fierce Healthcare. Each will be able to serve up to 1,000 families. Cortica operates in a value-based model, receiving bundled payments based on the acuity of the child and focusing on quality metrics of care. Point32Health will meet quarterly with Cortica’s clinical teams to evaluate the needs and progress of its members.
“Our new relationship with Point32Health represents a breakthrough in behavioral health by shifting to a whole-child, value-based approach, which advances health equity and access to care and rewards providers for their quality over quantity,” said Neil Hattangadi, M.D., co-founder and CEO of Cortica, in the announcement. “We are thrilled to expand into Massachusetts through our collaboration with Point32Health. I commend their leadership for seeing the future of autism care and doing what’s right for their members.”