Mount Sinai, Empire BlueCross BlueShield to extend access to home-based care models

A New York-based provider and payer are joining forces to expand access to value-based care models to more state residents.

Mount Sinai Health System and Empire BlueCross BlueShield have entered into a new agreement through which Empire members will gain access to three new care models: Mount Sinai Emergency Triage, Treat, and Transport; Mount Sinai Community Paramedicine; and Mount Sinai Visiting Doctors Program. The agreement extends to December 2025.

“The overarching goal [of the partnership] is value,” said Dr. Robert Fields, executive vice president and chief population health officer at Mount Sinai Health System, in an email. “Having a longer-term relationship allows us to plan a multi-year phased approach and grow together as partners.”

As a participating provider in the Mount Sinai Emergency Triage, Treat, and Transport and Mount Sinai Community Paramedicine care models, Empire will be able to provide its commercial members access to ambulance care teams that have flexibility with regard to emergency response.

For example, the Emergency Triage, Treat, and Transport model enables these teams to provide care at a patient’s home instead of taking them to the emergency room, when medically appropriate. This model is also available to Empire’s Medicaid members.

Similarly, the Community Paramedicine model allows members who call a clinician at Mount Sinai to choose to have a paramedic dispatched to their home and potentially avoid a trip to the emergency department.

The Mount Sinai Visiting Doctors Program is an integrated care model focused on homebound members. Qualifying Empire members that are enrolled in Medicare plans will have access to a dedicated clinical team providing primary and palliative care services.

“Today, as part of our mission, we signed a new agreement with Mount Sinai Health System to offer our members more options in terms of when, where, and how they receive care,” said Jordan Vidor, regional vice president of provider solutions at Empire BlueCross BlueShield, in the news release. “The new agreement features several innovative value-based care arrangements, with shared incentives to jointly improve the quality of care across our shared footprint.”

Empire will become a participant in the three care models by the first quarter of 2022.

The new agreement between the payer and provider not only expands access to value-based care but also details a plan for Mount Sinai to enhance bi-directional data integration with Empire.

“We are working with [Empire] on interfaces between our various platforms and theirs to promote more seamless data exchange with less manual input required from either team,” Mount Sinai’s Fields said.

The partnership is expected to improve the overall cost trend and quality of care, as demonstrated by both preventive care metrics, like cancer screenings, and measures that represent chronic illness outcomes, he added.

This agreement is the latest in a longstanding relationship between the two organizations. In 2015, Empire and Mount Sinai established an accountable care arrangement focused on care collaboration and increasing efficiency.

Photo: mediaphotos, Getty Images



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