- A Massachusetts payer is looking to connect its members with digital health programs promoting diabetes management and fertility, pregnancy and parenting guidance.
The Emerging Solutions platform being introduced by Blue Cross Blue Shield of Massachusetts in July targets self-insured health plans with at least 1,000 members and offers them covered services from three nationally recognized digital health companies. BCBSMA officials said they chose the services based on member feedback.
"We've heard from many of our employer customers that they are looking for new ways to help their employees with specific challenges including diabetes, pre-diabetes and maternity," Debbie Williams, Senior Vice President of sales and account services, said in a press release. "Emerging Solutions can address these needs.”
Williams said the platform will grow as BCBSMA identifies other digital health programs addressing specific healthcare pain points.
“We have a unique opportunity to continuously see the newest technological advancements in health and select those that will best benefit our members," she said.
The selected program partners are Livongo, a developer of mHealth tools and services for people with diabetes and other chronic conditions; Omada, which offers a Diabetes Prevention Program for members at risk of becoming diabetic; and Ovia Health, which offers digital health coaching and support for women from fertility planning through parenthood.
In launching the platform, BCBSMA is taking the lead in a state that has traditionally struggled to garner payer support for telehealth and mHealth programs. Lawmakers have been unable to pass legislation promoting payment parity for telehealth programs, and providers have said they need more government support to launch new programs that would address access issues to healthcare.
Just two years ago, a health policy brief developed by Health Affairs and the Robert Wood Johnson Foundation argued that telehealth and mHealth won’t succeed unless legislators and payers agree that providers should be reimbursed for digital health services at the same rate as for in-person care.
“As the United States moves from uncoordinated, volume-based delivery of health services to an integrated, patient-centric, value-based model, healthcare delivery will increasingly focus on achieving higher-quality care, improved care access and lower costs,” the brief stated. “In enabling healthcare organizations to provide high-quality, ‘anytime, anywhere’ care to patients and operate more cost effectively, telehealth programs play an important role in achieving these goals.”
In some cases providers have sought to negotiate their own telehealth and mHealth programs with health plans to address healthcare needs. In Alaska, for instance, Anchorage-based Medical Park Family Care worked with Livongo and Premera, the state Blue Cross and Blue Shield plan, to launch a remote monitoring program for members living with diabetes and looking for care management and coordination help.
“We’ve had a lot of discussions about care gaps, and we know there’s a big problem with diabetes in Alaska,” says Jennifer Dahline, Premera’s director of provider network management. “There’s not a lot of tools out there that are available for our members, so when we see a program like this, we’re telling providers to do it and we’ll pay for it.”