Florida Blue Collaborates with HOPCo to Address Health Care Affordability

Jul 06, 2022 at 02:41 pm by pj

New musculoskeletal collaboration aims to manage costs for treatment of bone, muscle and ligament injuries and disorders


Florida Blue, the state’s Blue Cross Blue Shield plan, and Healthcare Outcomes Performance Company (HOPCo) have joined forces to address health care affordability across the state. The collaboration aims to better manage costs for the treatment of bone, muscle and ligament injuries and disorders.

An estimated 126 million Americans are affected by a musculoskeletal condition, according to a report by the U.S. Bone and Joint Initiative. The report also estimates costs exceeding $200 billion each year for related treatment, medical care, and lost wages.

Through the new arrangement, HOPCo will develop and grow a clinically integrated network of community physicians and facilities treating bone, muscle and ligament conditions to participate in its Musculoskeletal Outcomes Management Program and risk-shared incentives. The program will initially focus on enhancing the quality and efficiency of care to Florida Blue's members being treated by HOPCo’s network of health care providers for the most common bone and joint repair procedures. The intent is to expand to all 26,000 ICD codes related to prevention and management of musculoskeletal condition care.

As part of the program, HOPCo will support a network of community physicians and facilities aligned to improve patient outcomes and reduce overall costs. This network will leverage HOPCo's standardized care protocols and its proprietary claim analytics and outcome management tools.

"As a mission-driven organization, Florida Blue remains focused on affordable, high-quality health care solutions for Floridians,” said Phil Lee, Florida Blue’s Vice President, Strategic Provider Partnerships. “Treatment of bone, muscle and ligament injuries and conditions accounts for a significant portion of health care costs each year for Florida Blue and our members. By working with Healthcare Outcomes Performance Company, we look to expand our partnership with musculoskeletal providers to not only slow rising health care costs, but also enable healthier lives for our members.”

Florida Blue is an innovative industry leader enabling healthy communities in the state of Florida. It continues to broaden the traditional scope of member care, shaping the evolution of value-based care to achieve better health.  HOPCo is a leading provider of musculoskeletal practice and outcomes management, value-based health care solutions and care coordination for musculoskeletal care and clinically integrated platform development. 

"We have proven the efficacy and benefits of this model in other markets across the country, and this collaboration is a significant step forward in the delivery of value-based care in Florida," said Dr. Wael Barsoum, President and Chief Transformation at HOPCo. "Our partnership with an organization with the size, scope and history of Florida Blue helps set the bar for changing the delivery of health care across the country."

Collectively, Florida Blue and HOPCo will create standard physician incentives for HOPCo’s network of health care providers that include adherence to evidence-based clinical protocols, care coordination and medically appropriate sites of care. This will further both organizations' pursuit of the triple aim of value-based care: lower costs, higher quality, and better patient experience. 

Florida Blue, Florida’s Blue Cross and Blue Shield company, has been providing health insurance to residents of Florida for more than 75 years. Driven by its mission of helping people and communities achieve better health, the company serves more than 5 million health care members across the state. Headquartered in Jacksonville, Fla., it is an independent licensee of the Blue Cross and Blue Shield Association.

Healthcare Outcomes Performance Company (HOPCo) is the national leader of integrated musculoskeletal value-based health outcomes management, practice management and health system service line management.  This includes comprehensive expertise across all MSK specialties, including orthopedics, spine, hand, pain management, rehabilitation, and neurology.  HOPCo's integrated care, analytics and facilities development platform has proven to increase the quality of patient care while reliably reducing the total cost of care across the care continuum for practices, health systems and payors alike.  HOPCo's affiliated payors, practices and health systems successfully participate in highly efficient value-based contracting (bundled payments, population health programs, and other advanced risk-based arrangements) utilizing HOPCo's proprietary platforms, IT solutions, integrated analytics, and standardized care pathways.  Visit www.hopco.com to learn more.