Two major players in Minnesota health care have teamed up on a new insurance plan they say removes obstacles that keep people from getting the best care.
The plan that Allina Health and insurer Blue Cross and Blue Shield of Minnesota unveiled Tuesday offers a handful of free office visits plus full coverage of many prescription drugs and lab screenings. It eliminates many co-pays.
The two organizations say the offering is the result of extensive interviews with patients and employers in an attempt to find out what they don't like about existing plans.
"We tried to strip everything out that got in the way of optimal patient care," said Dr. Robert Wieland, executive vice president of Allina's clinic and community division.
The partnership is an example of how health reform efforts and rising medical costs are pushing traditional adversaries to work together to coordinate patient care.
Providers face declining reimbursements for their work and are having to take on more responsibility for keeping patients healthier. There's greater incentive to use electronic medical records and claims data to avoid wasteful duplication of tests or to ensure that patients pick up their prescription drugs when they leave the clinic.
"It's an evolutionary step in the market, but there's a lot of merit to movement like this," said Steve Parente, a health care economist and professor at the University of Minnesota. "I can see it working both in terms of consumer appeal as well as in the nuts and bolts of the actuarial parts of it."
Known as "BluePrint," the plan will be available for individuals and families as well as large and small employers in the 11-county Twin Cities metropolitan area. It will be sold on the state's MNsure exchange starting in October as well as through brokers and Blue Cross.
The organizations say the price for the coverage will be lower than "open choice" plans Blue Cross offers because patients are limited to Allina hospitals, clinics and the 53 independent physician groups in its network.
A focus on chronic diseases
Although the plan will be open to anyone, it targets those with diabetes, hypertension and high cholesterol — three chronic conditions that can be costly for patients and providers if people wind up in the hospital.
Parente said working together is sound business strategy in an environment in which the newly merged HealthPartners insurance company and Park Nicollet system of hospitals and clinics are trying to lower costs by having everything under one roof.
An alignment of Blue Cross, the state's largest insurer, and Allina Health, a major health care system, to focus on chronic diseases has the same goal.
"If you can get these folks in, manage them by having them in your electronic health record system, make sure they get access to their medications, and manage to keep costs down, everybody wins," Parente said.
"The patient wins because they're going to be insured, the plan and providers win because they're going to capture some of this market and they're going to have demonstrated that they can keep costs relatively low."
Blue Cross led focus groups with doctors, as well as patients and employers, to try to figure out how to help people feel less overwhelmed and take a more active role in staying on top of their health.
The plan will incorporate a souped-up website where enrollees don't just fill out a health assessment form, but someone on the medical side evaluates the results and works with patients to help them achieve better health. Patients get discounts for participating in workshops.
"It's a big leap for us," said Garrett Black, senior vice president of health management at Blue Cross and Blue Shield of Minnesota. "In the past, we have created products without talking to people who deliver the care."
The result is something built from the ground up, Black said, rather than "taking an existing product and network and just bolting them together."