BOSTON, Feb. 25, 2020 /PRNewswire/ -- Blue Cross Blue Shield of Massachusetts (Blue Cross) is expanding its value-based payment model into the dental space with a first-of-its-kind arrangement with leading dental group 42 North. This partnership aims to improve the quality of members' oral and overall health, particularly those with chronic health conditions like diabetes and heart disease, since they can benefit from additional dental cleanings and exams. 42 North supports more than 70 dental practices, including Gentle Dental locations, from Maine to New York.
"We've seen outstanding results from our value-based payment model for our medical plans, including lower health care costs and better health outcomes for our members, and we think there is great potential for strong results for Dental Blue members as well," said Rich Greenhalgh, vice president of specialty benefits at Blue Cross. "We don't know of any other dental plan in the country offering this type of program."
Ten years ago, Blue Cross introduced a pioneering value-based payment model for physicians called the Alternative Quality Contract (AQC). A recent Harvard Medical School study published in the New England Journal of Medicine showed that over its first eight years, the AQC improved the quality of health care while moderating cost growth.
Under the new partnership and similar to our AQC for our medical plans, Blue Cross will give an incentive payment to 42 North providers who demonstrate measurable quality improvements in the oral and overall health of our Dental Blue members in addition to the standard payments we provide all dentists for their services.
As part of the Blue Cross Total Health program, Dental Blue members with certain chronic conditions also are eligible for enhanced benefits, such as extra dental cleanings and periodontal treatments, that can help them better manage their health condition and significantly reduce their medical costs.
"There is overwhelming evidence that dental care can aid in the management of several chronic health conditions, such as diabetes and heart disease," said Blue Cross Executive Director of Professional Services Dr. Bob Lewando, a periodontist. "This new incentive arrangement aligns with our focus on improving our members' total health because we will reimburse the dental practices for integrated, coordinated care that supports members' oral and overall health."
"We are so excited to be working with Blue Cross Blue Shield of Massachusetts to enhance the health of our mutual patients. Research has shown that the links between systemic and oral health are real, and we are proud to take the first steps together in ensuring our patients get the care they need. The alignment of providing the appropriate care at the right time to help our patients in need will be very powerful," said Dr. Michael A. Scialabba, vice president of clinical affairs for 42 North Dental.
Blue Cross's Dental Blue plan is the fastest-growing dental plan in the state, approaching one million members, the majority of whom also have BCBSMA medical coverage.
BCBSMA plans to evaluate the results of this new arrangement later this year with an eye toward expanding it to other dental practices in the future.
About Blue Cross Blue Shield of Massachusetts Blue Cross Blue Shield of Massachusetts (bluecrossma.com) is a community-focused, tax-paying, not-for-profit health plan headquartered in Boston. We are committed to the relentless pursuit of quality, affordable health care with an unparalleled consumer experience. Consistent with our promise to always put our members first, we are rated among the nation's best health plans for member satisfaction and quality. Connect with us on Facebook, Twitter, YouTube, and LinkedIn. We offer additional benefits like dental, vision, life, and disability through our Specialty Benefits area, which includes Indigo Insurance Services and Blue Benefit Administrators, our third-party medical claims administrator.
ABOUT 42 North Dental LLC 42 North Dental is a leading dental support organization in New England supporting 22 practice brands in 70 locations. With a mission to eliminate barriers to quality patient care by providing business and administrative support to dental practices, 42 North Dental presents opportunities that help doctors and their teams professionally advance while growing the business to its fullest potential. 42 North Dental's affiliation model offers dental providers clinical autonomy and equity ownership, as well as non-clinical solutions and the business support needed to increase the value of the practice. 42 North Dental was created by dentists for dentists and is rooted in over 40 years of experience in the dental industry.