PORTLAND, Ore. – Regence launched its value-based arrangement (VBA) provider networks in 2013 with the goal of improving member health, lowering overall costs and driving greater provider collaboration to achieve more efficient and effective care. The latest data from across the health plan’s four-state footprint demonstrates the gains accomplished through these innovative provider arrangements.
At least 40% of Regence health plan member claims currently flow through almost 120 value-based arrangements with provider partners, according to the latest 2018 year-end data. Results demonstrate significant improvements in care outcomes and savings over more traditional models, including:
- 6% lower costs
- 200% higher patient satisfaction scores, as judged by net promoter scores (NPS) among members in VBAs vs non-VBA arrangements
- 17% higher quality care gaps closed
- 33% lower catastrophic spend
- 14% lower opioid scripts filled
Regence’s VBA approach ties provider payments to quality versus quantity of care. For 2018, the health plan paid more than $15.8 million in total provider payments (including Medicare Advantage) linked to specific quality measures that address gaps in care, encourage clinical best practices and promote important preventive screenings. More information about Regence’s VBA approach can be found in a new white paper “Where collaboration meets innovation.”
“Our success achieving better outcomes at lower costs for our members in partnership with providers, and the long history with value-based arrangements reinforce our leading position as a company dedicated to transforming care,” said Dr. Cheryl Pegus, Regence’s president of consumer health solutions and chief medical officer. “As we look to the future, we are continuing to prioritize collaborative arrangements with providers who embrace data-driven approaches to improving the quality, safety and affordability of patient care.”
Regence’s value-based programs range from an inclusive care management model called Total Care, to value-based networks that create a deeper engagement between the patient and the provider. In November of 2019, the health plan announced a new program called Episodes of Care, the first to focus specifically on clinical procedures. Episodes of Care compensates providers for delivering improved patient outcomes and lower costs over a patient’s “episode of care” for a procedure or condition – such as a knee replacement or cardiac procedure – over a defined period of time.
Regence is committed to supporting health care professionals during the COVID-19 pandemic. Steps taken include expanding virtual care access, expediting provider payments and credentialing to help meet emerging demands, advocating for providers to receive additional federal aid, and more here.
Regence serves approximately 3.1 million members through Regence BlueShield of Idaho, Regence BlueCross BlueShield of Oregon, Regence BlueCross BlueShield of Utah and Regence BlueShield (select counties in Washington). Each health plan is a nonprofit independent licensee of the Blue Cross and Blue Shield Association. Regence is part of a family of companies dedicated to transforming health care by delivering innovative products and services that change the way consumers nationwide experience health care. For more information, please visit regence.com.