Blue Cross Blue Shield Value-Based Care Program

The Blue Cross and Blue Shield Association (BCBSA) and BCBS Plans are spearheading initiatives to assure their 100 million members receive safe, high-quality, coordinated, and affordable care. Blue initiatives use an interconnected approach involving:

• Changing payment incentives by moving away from fee-for-service – which rewards volume – and linking reimbursement to quality and outcomes.
• Partnering with clinicians so they have the individualized support, data, and tools they need to be successful.
• Engaging patients with wellness programs, transparency tools, and information on how to keep healthy and manage chronic conditions.
• Blue Cross and Blue Shield Plans are leading the market in developing and executing value-based care programs for our members. With more than 350 programs in market across 49 states, Washington DC, and Puerto Rico, these programs focus on shifting provider payment away from volume to value. The Blues are engaging with more than 215,000 physicians – 155,000 primary care physicians and nearly 60,000 specialty physicians – to increase quality and value in healthcare spending. More than 24 million Blue Cross and Blue Shield members are currently accessing care through value-based programs such as Accountable Care Organizations, Patient-centered Medical Homes, Pay-for-Performance programs and Episode-based Payment programs.

37 Blue plans have more than 350 value-based programs in market or in development, with more than 215,000 particiapting providers providing care to nearly 24 million members. 

237 ACOs in 41 states and D.C. with more than 93,000 physicians participating. 

63 PCMH models in 48 states, D.C. and Puerto Rico with over 36,000 physicians participating.