Provider Partners
BCBSRI is teaming up with providers and others to build a higher quality, more affordable, and more equitable healthcare system. A focus on quality over quantity of healthcare. Attempts to address the rising cost of prescription drugs. Encouraging diversity that reflects our community. These initiatives can make a real difference for all Rhode Islanders.
Promoting “well care” over “sick care”
We are investing in primary care to enable clinicians to focus on preventive health and keeping patients healthier. Not only is that better for patients, but it also drives down costs, which is better for employers and the system. Physicians who deliver higher quality thrive, receiving greater financial incentives, which enables them to bring on additional care team members and see more patients.
Value-based care with Prospect
In 2022, we launched an exciting arrangement with Prospect Health Services of Rhode Island, compensating them for taking holistic care of their nearly 10,000 BCBSRI Medicare Advantage patients, rather than for specific services provided.
Key to this approach is team-based care, where physicians can spend more time with patients who have more acute needs. Then other members of the care team can spend time with patients whose needs are preventive, for instance having a dietitian consult with a patient on a heart-healthy diet.
“We are pleased that BCBSRI has taken this bold step forward in supporting value over volume.”
Addressing prescription drug costs
While many generic medicines cost less than brand-name drugs, some high-cost generics are more expensive than they need to be due to lack of competition in the market. BCBSRI welcomed the first low-cost generic drug to be produced through our partnership with CivicaScript™, which was cofounded to bring affordable versions of common but high-priced generic medicines to market. CivicaScript introduced tablets to help treat prostate cancer that has spread to other parts of the body. BCBSRI cofounded CivicaScript in 2020 along with Civica Inc., the Blue Cross Blue Shield Association, and 17 other independent and locally operated Blue Cross and Blue Shield companies.
Read what our CEO, Martha Wofford, has to say about making healthcare more affordable
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Civicascript’s maximum retail price
Prescription savings program
In 2022, BCBSRI introduced MedsYourWay®, a drug discount program available to many of our members. It helps them find the lowest available price of applicable discount cards for eligible medications—no coupons or other cards needed.*
*MedsYourWay is not insurance. It is a drug discount program administered by Prime Therapeutics, LLC, an independent company contracted by BCBSRI to provide pharmacy benefit management services.
Collective buying power
In 2022, BCBSRI helped lay the groundwork for a new collective purchasing organization, Synergie. Founded by Blue Cross and Blue Shield companies, Synergie will negotiate costly medical benefit drugs—ones that are injected or infused by a healthcare professional in a clinical setting—for 100 million Americans, starting in 2023.
Pharmacists embedded at integra
*Savings include direct and indirect costs in 2022 by pharmacists with Rhode Island Primary Care Physicians Corporation.
Making behavioral healthcare more equitable
The last few years have emphasized the importance of mental healthcare—and the need for increased access to those services. We are collaborating with community partners to ensure that everyone in our community receives affirming and inclusive care.
An open door for the LGBTQ+ community
Since 2019, we’ve been proud to support Open Door Health, Rhode Island’s first and only clinic dedicated to providing primary care and sexual healthcare to the LGBTQ+ community. In 2022, we helped fund an integrated behavioral healthcare program with on-site psychologists at the clinic.
Support for diverse mental health professionals
In the behavioral health field, the lack of diversity among providers contributes to a lack of diversity in people seeking mental healthcare, including the BIPOC and LGBTQ+ communities as well as speakers of world languages. That’s why BCBSRI is helping fund the Mental Health Association of Rhode Island’s Diversity, Equity, and Inclusion Pipeline. Through this program, scholarships and internship stipends are awarded to graduate students from diverse backgrounds who will eventually practice in Rhode Island.
Latinos & Mental Health Project
The Latino Policy Institute at Roger Williams University has partnered with BCBSRI and the Latino Mental Health Network of Rhode Island to implement the Latinos & Mental Health Project. It is analyzing barriers and opportunities in the Rhode Island workforce pipeline for mental health professionals. Next year it will propose improvements and investments in the mental health workforce pipeline for multilingual and historically underserved communities and providers.
Navigation for Crossroads clients at high risk
In 2022, BCBSRI funded a new program at Crossroads that provides mental health navigation services to clients in Crossroads’ Domestic Violence Program, Women’s Shelter, Family Shelter, and Rapid Rehousing programs. Having this targeted support will help clients improve their mental health and achieve housing stability.
Behavioral healthcare right in the (free) clinic
COVID-19 has highlighted the need for more support for the behavioral and social needs of clients at the Rhode Island Free Clinic. With support from BCBSRI, the Free Clinic welcomed their first full-time behavioral health clinician in 2022.
Encouraging providers and suppliers
BCBSRI is committed to creating opportunities for all Rhode Islanders, from the providers who see our members to the companies we do business with.
Safe Zones
2022 saw a significant increase in the number of BCBSRI-certified Safe Zone providers offering safe, affirming, and inclusive care to the LGBTQ+ community.
The Safe Zone program has grown to include adult and pediatric primary care, behavioral health, oral health, assisted living for older adults, child and family services, and organizations serving individuals who have experienced sexual assault, domestic abuse, and substance abuse.
Certification requirements for BCBSRI LGBTQ+ Safe Zones include staff training specific to the care of LGBTQ+ patients, protection for patients and staff from discrimination based on gender identity or expression, gender-neutral bathrooms, inclusive forms and procedures, and a public commitment to connecting with and serving the LGBTQ+ community.
The Rhode to Pride
listen to podcast“The Safe Zone program was created to help address the historical challenges the LGBTQ+ community has encountered in obtaining healthcare.”
Supplier Diversity
BCBSRI brought on board a dedicated Supplier Diversity Program Manager, Doris De Los Santos, to lead supplier diversity efforts within the organization and build relationships externally to help us achieve our short- and long-term supplier diversity goals. We are committed to increasing our procurement of products and services from minority-, women-, LGBTQ-, disability-, and veteran-owned businesses, as well as small disadvantaged, HUBZone, and local small businesses.
“I am ready to get to work on the supplier diversity front. This is the perfect time to support diverse businesses in Rhode Island, as the state continues to recover from the effects of the pandemic.”
Reaching more Rhode Islanders with needed services
A technology upgrade that helps improve lives
In 2022, BCBSRI provided $1.5 million in funding to enhance the capabilities of 211, United Way of Rhode Island’s free 24/7 resource for people in need of housing, food, and other assistance.
Now, when someone calls 211 for help or lets a healthcare provider know they are in need, their information is entered into a confidential technology platform that connects a network of health and social care providers. An electronic referral is tracked in the system, allowing 211 staff and healthcare providers to ensure that individuals are connected with the best program to address their needs.
“We need to ensure Rhode Islanders have safe and affordable housing and nutritious food, and that we’re able to measure the benefits on the health of individuals and communities. We are beyond thankful to BCBSRI for not only sharing this vision, but also for their generous support of the work to get there.”
Health programs in neighborhoods
To help Clínica Esperanza/Hope Clinic expand access to programs, we supported their recently established Neighborhood Health Station, which offers free walk-in health screenings as well as walking clubs, Zumba, and Vida Pura, a program that outreaches to individuals struggling with substance use.
“We need to ensure Rhode Islanders have safe and affordable housing and nutritious food, and that we’re able to measure the benefits on the health of individuals and communities. We are beyond thankful to BCBSRI for not only sharing this vision, but also for their generous support of the work to get there.”
