In 2013, Blue Cross & Blue Shield of Rhode Island will introduce a new health-insurance product, a shared-savings, limited-network plan, in collaboration with one or more of the state’s seven hospital systems, Blue Cross President and CEO Peter Andruszkiewicz told Providence Business News.
“I originally thought that because of our size and scale that we could make delivery-system changes without doing a tiered, limited network,” Andruszkiewicz said July 31. “I was naïve.” Blue Cross is going to be taking steps in 2013, he continued, to introduce the new plan, building on the approach of the recently completed shared-savings contract with Coastal Medical. “We will be working with enlightened partners, who can go faster in terms of contracting and incentive changes,” he said.
When asked which hospitals and physicians groups he was talking with, Andruszkiewicz declined to identify any specific hospital or group practice. He said Blue Cross had been talking with virtually every hospital system, whether their contract was coming up for bid this year or not, to share with them plans for where Blue Cross wants to go in the future.
The Blue Cross executive acknowledged that similar tiered, limited-network products had been introduced into the Massachusetts market by Tufts Health Plan in collaboration with Steward Health Care, and he anticipated that UnitedHealthCare of New England would also be developing a similar plan.
The new plan reflects Blue Cross’ goals to improve access, quality and affordability for its members. Many current plans allow unlimited access. Limited-network plans would restrict choices by customers in exchange for lower costs and the hope of higher quality of care.