Blue Cross to Increase Reimbursements to Small, Independent Practices in Massachusetts

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Changes are coming to the Massachusetts health care network.

Blue Cross Blue Shield of Massachusetts is increasing its reimbursement rates to select independent primary care practices in the state. In a press release,¹ Blue Cross explained that the move is part of plan to improve access to doctors in the state. According to the organization, 2023 set a new record for patients in the state saying they were unable to see their doctor when they needed to.

The reimbursements are considered a form of funding for the smaller healthcare practices. According to the press release, practices that qualify may start seeing increases in reimbursements of up to 30%.

In a press release, Blue Cross president and CEO Sarah Iselin said, “We need to support our primary care clinicians now more than ever before. We are committed to doing our part to sustain and strengthen primary care in the Commonwealth to help ensure everyone can access the care they need, when they need it most."

In the same press release, Blue Cross senior vice president of performance measurement & improvement Mark Friedberg, MD, said, “Investing in primary care should start where it is needed most–with small, independent practices. These practices provide high-value services for our members, and we need to do what we can to support them during this critical time. We also know that strengthening primary care helps improve outcomes and overall health care affordability."

Blue Cross’ press release references the results of a recent annual survey conducted by Massachusetts Health Quality Partners.² While the results of the Patient Experience Survey, published in early 2024, show some improvements over recent years, the category “ease of access to care” shows a decrease.

In 2019, the category scored an 86.6. During the pandemic, that number droped to 83.2 and 82.8. Finally, in 2023, that number settled at 82.3, suggesting that patients in the state are finding it more difficult to get access to care when they need it.

In a press release issued by Massachusetts Health Quality Partners, the group’s CEO and president Barbra Rabson said, “Primary care practices deserve our praise and gratitude. They have risen above enormous obstacles in the past few years to deliver improved patient experiences for patients. This is remarkable. However, access to primary care is getting significantly worse and is contributing to emergency room back-ups and other system imbalances. At the same time, the percentage of total medical expense supporting primary care in Massachusetts is declining. This crisis needs immediate attention.”

Source

1. Blue Cross Blue Shield of Massacusetts to Boost Investment in Small Independent Primary Care Practices. Blue Cross Blue Shield of Massachusetts. April 8, 2024. https://www.prnewswire.com/news-releases/blue-cross-blue-shield-of-massachusetts-to-boost-investment-in-small-independent-primary-care-practices-302110393.html
2. Patient Experience Scores for Adults Improve Since Before the Pandemic, Except in One Key Area: Access. MHQP. February 2024. Accessed April 8, 2024. https://www.mhqp.org/2024/02/13/patient-experience-scores-for-adults-improve-since-before-the-pandemic-except-in-one-key-area-access/