In 2019, the Blue Cross Blue Shield Association launched its high-performance network, dubbed Blue HPN. To date, 45 employers have chosen to offer Blue HPN as a network option for their employees, a number Jennifer Atkins, vice president of network solutions at BCBSA, said is set to grow.
Ms. Atkins joined healthcare on the delivery side of things, where she worked on contract negotiations from the provider perspective within a health system that later became Cincinnati-based Bon Secours Mercy Health. An urge to better understand the payer perspective led her to a role at Anthem, and later to her current position at BCBSA, where she is responsible not only for Blue HPN, but also the association's Centers of Excellence programs, value-based care programs, and other network reporting and quality efforts.
The Blue HPN is unique in that it's one of the first big national pushes from BCBSA, which represents 36 independent Blue companies, in more than 25 years. Saving costs for employers is a key component of the network, which it aims to do by pairing employees with providers that are known for giving care that's high quality and efficient.
Employers who began participating in the program Jan. 1 had to choose to do so in late 2019 and 2020. Because of the COVID-19 pandemic, Ms. Atkins said she didn't know how well Blue HPN was going to land on the market. Some employers were willing to make changes, while others chose to file away the network for another year with less complexity.
To date, the Blue HPN footprint spans 55 markets, which include the biggest 10 cities in the U.S. Depending on the size of the 45 employers that signed on to the network for 2021, 340,000-plus employees and their dependents are potentially eligible for the network.
In the Blue HPN, tying payment to quality can translate to an average 11 percent in total cost of care savings for employers, and up to 20 percent in some markets, when compared to a BlueCard PPO plan, Ms. Atkins said. The BlueCard PPO plan already has 5 to 9 percent lower total cost of care when compared to other national payers, she added.
Blue HPN has eight national performance measures aimed at managing total cost of care for a population that are consistent across all markets (asthma, imaging studies for low back pain, elective deliveries in maternity, engagement of substance use treatment, breast cancer screening, statin therapy, unplanned hospital readmissions and infections). There are another eight measures that are specific to each market, with some focusing on vaccines and maternity safety, depending on community needs.
"We're using quality measures that are known in the industry. We're not looking to create or add anything new. What we were looking for was quality measures that close gaps in healthcare," Ms. Atkins said.
As the program is national, Ms. Atkins said strong communication is needed to create consistency within a flexible framework.
"We aim for consistency across the program, consistency across the plan, but then again recognizing that healthcare is very local," she said. She added that data is shared at the plan level, and there's "more to come as we continue to work with plans on [national evaluations]."