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Global Risk Agreement

Written By: Chris - Sep• 21•21

The DMHC provided further guidance on the new rules, which specify that the following agreements between licensed plans, hospitals and provider groups must not apply for a licence or exemption: pooled payments, case rates, diagnosis-related group payments, contracts for professional services provided by a hospital emergency room, certain payment-per-day agreements and certain agreements for which a service provider: assumes only the financial responsibility of the professional supervision. It can be provided in a hospital facility, but the provider does not share savings or losses in the hospital. Providers also do not have to apply for a license or exemption to participate in an Accountable Care Organization agreement or for risk-sharing agreements with insurers licensed by the California Department of Insurance. We are particularly pleased with this new contract as it gives us time, as a seven-year contract, to work with BCBSMA to make healthcare easier and more affordable for our patients and to work with BCBSMA`s employer clients in a new way. As of July 1, a business that assumes a “global risk” must obtain a license to operate a health plan or apply for a waiver. The DMHC defines “overall risk” as the acceptance of a prepaid or periodic fee by or on behalf of the participants in return for the assumption of both the occupational and institutional risk. Occupational risk includes the cost of providing licensed professional services to a plan member, while institutional risk involves the costs of providing hospital services. The Trans-Pacific Partnership, widely hailed as the largest free trade agreement in history, includes 12 Pacific countries that account for 40% of global GDP and 25% Through our new agreement with Blue Cross Shield Blue Blue of Massachusetts (BCBSMA), we take full responsibility for the total cost and quality of supply to more than 70,000 OPP members, who matter, who our patients are. Given that we are proven to succeed in global risk contracts and have the opportunity to work with this leading contributor to improve the care experience for our patients, we are confident that moving this patient population from the service fee to an alternative payment model will have a positive impact on patients, BCBSMA and Atrius Health. The processes, technology and employee engagement needed for quality care have been carefully developed over time, as we have increased the number and scope of our full-risk contracts. With this new BCBSMA collaboration, 65% of Atrius Health`s patients are cared for under global risk contracts, representing more than 80% of our annual revenue.

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