Blue Cross Blue Shield Will Reward Doctors Who Reduce Racial Inequalities In Health Care

Massachusetts' largest private health insurer is taking a new approach to address disparities in care for people of color.

Blue Cross Blue Shield of Massachusetts says it will financially reward doctors who improve care for Black, Hispanic and Asian patients. Blue Cross executives say amid the recent racial justice reckoning after the murder of George Floyd last year and the pandemic, they want to focus on narrowing the differences in care among white patients and patients of color.

"We are taking these steps to really, in an intentional way, try to improve the equity of care, because this has been a longstanding interest of the company," said Dr. Mark Friedberg, Blue Cross Blue Shield of Massachusetts Senior Vice President of Performance Measurement and Improvement. "We elevated equity of care as a fourth strategic priority for the company on par and equal in status with the quality, affordability of care and having an excellent customer experience."

The insurer analyzed 2019 data from more than one million Massachusetts patients and found racial disparities in areas including colon cancer screening, adolescent checkups and depression treatment. For example, the analysis found 69% of Black and 70% of Hispanic adolescent patients went to their doctors for checkups, compared with 80% of white patients. The data also showed that 64% of Black patients got colonoscopies, compared with 71% of white patients.

"Honestly, it's humbling," Friedberg said. "It means that we have a ways to go in improving the equity of care. It's going to take a sustained effort, a large investment and the partnership of our provider network and community partners inside and outside the health care system."

Friedberg says details of the financial incentives are still being worked out, but they would apply to doctors who care for Blue Cross Blue Shield members in Massachusetts and could be implemented by 2023.

Other components of the insurer's plan to address equity are providing support and collecting data, according to Friedberg. He says BCBS will work with the Institute for Health Care Improvement to create a forum to share data and best practices.

Friedberg says state officials are working on redesigning MassHealth, the state's public insurance program. The redesign would require providers to measure and reduce disparities in care, and would link payments to health equity. The state's plan requires federal approval.

He hopes other insurers take similar steps.

"Any payer can do what we just did," Friedberg said. "Any payer anywhere in the country already calculates its own quality measures and can produce an internal report at a minimum and then has the option to publish those reports, to enhance the ability of all of us to be jointly accountable for improving the quality of care for all of our populations."