Blue Cross Blue Shield of Massachusetts has partnered with American Well to pilot the company's video visits offering, called WellConnection, with two physician groups, Emerson Physician Hospital Organization (Emerson PHO) and Lowell General Physician Hospital Organization (LGPHO). BCBSMA nurse care managers will also pilot the offering with members.
WellConnection is a white-labeled version of American Well's digital video visits offering that helps patients consult with physicians via their computers, smartphones, or tablets.
The physician groups participating in the pilot are a part of BCBSMA’s Alternative Quality Contract (AQC) program, which is what the payor calls its accountable care initiative. BCBSMA launched its AQC model in 2008.
Over the course of the two-year pilot, providers will use WellConnection to conduct video visits with patients to address a variety of health issues that are ultimately up to the discretion of the participating physicians. BCBSMA offered up a few examples: providers can use the offering to monitor a patient's concussion recovery, offer wellness coaching, check the patient's response to a medication, or monitor a patient's recovery after they were hospitalized.
BCBSMA Director of Network Innovation Greg LeGrow told MobiHealthNews that video visits have the potential to improve cost, access, quality, efficiency, as well as patient and physician satisfaction.
"On the cost and utilizations front, we really see telemedicine having the capability to better manage cost by scheduling and shifting certain portions of care to a telemedicine or video visit," LeGrow said. "Number two is preventing potential unnecessary emergency department visits as well as shifting some of those visits to other resources. So moving it from, perhaps, a physician to physician extenders or nurse practitioners. We also think there is an ability to improve access. That's really just providing patients with more timely, convenient, and cost affective alternatives to coming into the office."
LeGrow added that although cost, access, and satisfaction are important,the cornerstone of Alternative Quality Contract is to improve quality and video visits will help with this, especially because, he said, this offering can help providers better manage patients' chronic conditions, which generally require more frequent follow-ups.
BCBSMA is encouraging providers to use this tool with all of their patients -- even those who are not covered under Blue Cross -- but physicians have the discretion to waive fees for their Blue Cross insured patients.
"Not all providers might want to waive fees for Blue Cross of Mass members for every use case," LeGrow said. "If it is to a deal with a simple acute condition, such as a sinus infection, a headache, a urinary tract infection, they may still want to have that service fee and have that service fee be a governor, just like a copay does -- to have the patients have some skin in the game. But for conditions where they typically don't bring patients into the office, if they're doing chronic condition management and following up with phone calls, they may want to do that video visit. We believe that a video visit could improve engagement with these members and in those cases they'd probably think of waving those fees."
An early version of this pilot was first announced in July 2013, but wasn't launched until now.
"We have worked very hard to find the right groups who were interested and willing to participate and honestly have the right use cases put forward in order to test the efficacy of telemedicine," LeGrow explained. "So this is coming to fruition."
When the pilot was announced, American Well CEO Dr. Roy Schoenberg said BCBSMA was one of the first payors "to embrace telehealth under the flag of improving [care] quality".
The two practices from the Lowell General Physician Hospital Organization participating in the trial are Mill City Medical Group of Lowell and the office of Damian Folch of Chelmsford. Emerson PHO is still identifying which practices from its organization are participating.