Blue Cross and Blue Shield of Minnesota is the largest non-profit health plan based in our state, covering nearly 3 million members across all market segments. Effective APMs are core to our strategic plan of transforming and reinventing the health care system. One of the truths this pandemic has revealed is the unsustainability of a volume-based health care world where the profitability of sickness is greater than the profitability of wellness. COVID-19 has hastened the need for change to this old paradigm.
Throughout the pandemic, we have been a leader in forging innovative solutions to improve our state’s response. We were the first health insurer to join the state’s latest public health initiative to slow the spread of COVID-19, signing up more than 140 associates from across Blue Cross to volunteer as contact tracers for the Minnesota Department of Health. We also joined forces with a local health system to have local volunteers create and donate thousands of hand-sewn masks, preserving the supply of critical personal protective equipment for front-line workers.
Our response to the pandemic has focused on ways to use, encourage and improve effective APMs. In short order we implemented efforts to strengthen and stabilize our care delivery system. We provided cash-flow relief to providers in APMs, accelerating approximately $80 million in advance payments to providers for quality and cost standards achieved in 2019. We also advanced payments to providers for achievements made in innovation and transformation of care.
We have begun to build APMs with a coalition of rural hospitals. The preliminary focus with these hospitals is to build a model that emphasizes overall sustainability, both in terms of costs and continued access to rural health care.
We announced an APM partnership with the state’s largest care system and a network of 47 independent practices. Our new six-year, value-based payment agreement with Allina Health features expanded care management services and care coordination, more affordable sites for care delivery and more diverse access channels; timely data sharing; increased options for telehealth; and, crucially, a focus on improving quality and preventive care. The agreement aims to reduce the cost trend of Blue Cross-specific care at Allina Health by 10 percent over five years and will help more Minnesotans to improve and maintain their health.
And finally, the pandemic has not derailed our efforts to address health equality in Minnesota. Blue Cross and Blue Shield of Minnesota believes that all people, regardless of race, income, ZIP code or other factors, should have opportunities to live the healthiest lives possible. We are continuing to make wellness and health equity growing priorities for all of our APMs, with a sharpened focus on metrics, transparency and programmatic investments that can address racial and health disparities throughout Minnesota. We will be building into our quality provider programs specific and targeted quality improvement goals to reduce health disparities.
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Emily DuHamel Brower, M.B.A., is senior vice president of clinical integration and physician services for Trinity Health. Emphasizing clinical integration and payment model transformation, Ms. Brower provides strategic direction related to the evolving accountable healthcare environment with strong results. Her team is currently accountable for $10.4B of medical expense for 1.6M lives in Medicare Accountable Care Organizations (ACOs), Medicare Advantage, and Medicaid and Commercial Alternative Payment Models.
Mr. James Sinkoff is the Deputy Executive Officer and Chief Financial Officer for Sun River Health (formerly known as Hudson River HealthCare), and the Chief Executive Officer of Solutions 4 Community Health (S4CH); an MSO serving FQHCs and private physician practices.
Victor is the Chief Medical Officer for TennCare, Tennessee’s Medicaid Agency. At TennCare, Victor leads the medical office to ensure quality and effective delivery of medical, pharmacy, and dental services to its members. He also leads TennCare’s opioid epidemic strategy, social determinants of health, and practice transformation initiatives across the agency. Prior to joining TennCare, Victor worked at Evolent Health supporting value-based population health care delivery. In 2013, Victor served as a White House Fellow to the Secretary of Health and Human Services. Victor completed his Internal Medicine Residency at Emory University still practices clinically as an internist in the Veteran’s Affairs Health System.
Dr. Brandon G. Wilson, DrPH, MHA (he, him, his) joined Community Catalyst as the Director of the Center for Consumer Engagement in Health Innovation, where he leads the Center in bringing the community’s experience to the forefront of health systems transformation and health reform efforts, in order to deliver better care, better value and better health for every community, particularly vulnerable and historically underserved populations. The Center works directly with community advocates around the country to increase the skills and power they have to establish an effective voice at all levels of the health care system. The Center collaborates with innovative health plans, hospitals and providers to incorporate communities and their lived experience into the design of systems of care. The Center also works with state and federal policymakers to spur change that makes the health system more responsive to communities. And it provides consulting services to health plans, provider groups and other health care organizations to help them create meaningful structures for engagement with their communities.
Tamara Ward is the SVP of Insurance Business Operations at Oscar Health, where she leads the National Network Contracting Strategy and Market Expansion & Readiness. Prior to Oscar she served as VP of Managed Care & Network Operations at TriHealth in Southwest Ohio. With over 15 years of progressive health care experience, she has been instrumental driving collaborative payer provider strategies, improving insurance operations, and building high value networks through her various roles with UHC and other large provider health systems. Her breadth and depth of experience and interest-based approach has allowed her to have success solving some of the most complex issues our industry faces today. Tam is passionate about driving change for marginalized communities, developing Oscar’s Culturally Competent Care Program- reducing healthcare disparities and improving access for the underserved population. Tamara holds a B.A. from the University of Cincinnati’s and M.B.A from Miami University.
Dr. Peter Walsh joined the Colorado Department of Health Care Policy and Financing as the Chief Medical Officer on December 1, 2020. Prior to joining HCPF, Dr. Walsh served as a Hospital Field Representative/Surveyor at the Joint Commission, headquartered in Oakbrook Terrace, Illinois.
