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Mayo Clinic, Blue Cross and Blue Shield of Minnesota announce five-year agreement

The agreement is structured to offer comprehensive clinical strategies that support the health of the population in southern Minnesota.

Jeff Lagasse, Associate Editor

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Blue Cross and Blue Shield of Minnesota and Mayo Clinic have announced a new agreement that will keep all Mayo locations across Minnesota in the Blue Cross provider network through 2023.

This five-year agreement, which takes effect January 1, 2019, is structured to offer comprehensive clinical strategies that support the health of the population in southern Minnesota, as well as to maintain ongoing support of complex specialty care provided by Mayo Clinic.

By ensuring access to Mayo Clinic's clinical and diagnostic expertise for patients with complex medical conditions and needs, the companies said the agreement will help Blue Cross members with commercial or government coverage reduce avoidable costs caused by misdiagnoses or unnecessary treatment plans.

Under the agreement, Blue Cross and Mayo Clinic will establish a collaborative governance structure to ensure that advancements in medical technology and procedures have a path to market through health plan coverage options. Advancements in organ transplants, radiation therapies and genomics are some of the areas the organizations are committed to support through a collaborative guided-care approach -- ensuring individuals who would benefit from complex care can seamlessly navigate to to Mayo Clinic to receive care.

"This five-year agreement combines and compliments our respective strengths," said Garrett Black, senior vice president of Health Services and Enterprise Solutions at Blue Cross and Blue Shield of Minnesota. "Blue Cross has unique expertise in improving quality outcomes and addressing the cost of care for our members with highly complex health issues that require extensive medical services and support. Mayo is a global leader in models of care that provide these types of highly specialized, innovative and integrated services. By working together, we can collaborate on the most effective ways to utilize emerging and breakthrough technologies in ways that are sustainable."

Dennis Dahlen, chief financial officer at Mayo Clinic, said the member and patient experience "has been front and center in our discussions with Blue Cross and Blue Shield of Minnesota. Our formal governance structure will advance both organizations' capabilities to positively affect the health and wellness of consumers in our marketplace, and provide long-term rewards for consumers."

The guided-care approaches are designed to enable Blue Cross members to access high-value care cost-effectively. For example, a guided-care approach would identify members in need of Mayo Clinic care through Blue Cross' High Complexity Case Unit and Mayo Clinic's Complex Care Program. The collaboration enables members to address their complex clinical needs, reducing the total cost of care by placing the patient on the right treatment plan as quickly as possible.

Network design and provider participation can vary by health plan. Before obtaining services, Blue Cross members should call the number on the back of their Blue Cross membership card to verify whether Mayo locations are within their health plan network.

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com

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