L.A. Care Health Plan and Blue Shield of California Promise Health Plan announced Wednesday they will jointly operate 14 new and existing community resource centers throughout Los Angeles county.
The effort is part of a $146 million investment from both insurers over a five-year period with each group investing $73 million. Such a collaboration among two insurers, which are typically competitors, is unique. But John Baackes, CEO of L.A. Care, said there is an advantage to working with Blue Shield Promise because they share members. Blue Shield Promise contracts with L.A. Care to offer Medi-Cal, California's Medicaid program.
"I don't know of any arrangement where there is a subcontracting relationship between plans that would otherwise be competitive and as a result, I don't know of any collaboration like this in the country," Baackes said.
L.A. Care Health Plan already operates six community resources centers and had been looking for ways to expand the services before Blue Shield Promise agreed to help with funding. The centers, which provide free services to the public and members related to areas like nutrition, fitness and childhood development, are incredibly popular in the community, Baackes said. Some community members have relied on the services for years.
The expansion of the centers is part of a larger strategy from both health plans to address social determinants of health.
"We are humble enough to know that what really impacts the majority of individuals are some of the social situations our members experience," said Dr. Greg Buchert, CEO of Blue Shield Promise. "And since we deal with the Medicaid population, we know that some of our members are maybe socially, culturally or linguistically challenged and having these resource centers available to them ... we can help them in their daily activities and along the way improve their health status."
Both health plans intend to track the members that use the centers and then how it impacts outcomes such as emergency room utilization.
"We absolutely want to see if there is a return on investment, this isn't just a PR gesture," Baackes said.
The centers will also enable both health plans to transition much of their care management services from over the phone to in-person. Right now, most members speak to community health workers or nurse care managers on the telephone because they aren't located close enough to meet face-to-face. The new centers will be strategically located close to members and be staffed with community health workers and nurse care managers.
"We want to facilitate more face-to-face connection between our care teams and the members we serve," Baackes said.
By the first quarter of 2021, the two health plans plan to open seven new community resource centers and co-brand all 14 centers with both logos, Buchert said.