CareFirst BlueCross BlueShield and Ryse Health Partner to Accelerate Value-Based Care for Diabetes Patients
CareFirst and Ryse Health introduce quality improvement program to achieve better health outcomes for members with uncontrolled diabetes
Washington, D.C. and Baltimore – Today, CareFirst BlueCross BlueShield (CareFirst), the largest not-for-profit health plan in the mid-Atlantic region, and Ryse Health (Ryse), an operator of specialized cardiometabolic health clinics, announced a first of its kind quality improvement partnership serving individuals with uncontrolled type 2 diabetes in CareFirst’s commercial networks.
The program will pair Ryse providers with CareFirst members in Washington, D.C., Maryland, and Northern Virginia with uncontrolled Type 2 Diabetes. Ryse will combine a mix of in-person and virtual care interactions to help patients control their HbA1c and blood pressure and conduct timely diabetes-related health screenings so early detection and interventions are available. This patient-centered focus can help improve health outcomes, patient experience, and the affordability of care.
“Considered one of America’s top public health burdens, diabetes is a huge challenge for many of our members,” said Brian Wheeler, senior vice president of health services at CareFirst. “We’re excited for this partnership with Ryse, and to be implementing a hybrid management approach to diabetes care that improves access, strengthens the provider-patient relationship and supports members in a way that gives them the confidence to take control of their daily routines.”
CareFirst and Ryse began conversations in 2021, and in 2022 Ryse joined the second cohort class of 1501 Health, a national healthcare incubator program run by LifeBridge Health and Healthworx, CareFirst’s innovation and investment arm.
Both Ryse and CareFirst are driven by a value-based care system that focuses on care quality and patient health outcomes rather than the quantity of services. Ryse’s approach emphasizes frequent engagement with patients to help them improve their health. Ryse co-founder and CEO Richard Gurley said the company has observed that, on average, patients in the National Capital Area wait four months to see an endocrinologist and then often see their provider only every three to six months. Ryse strives to maintain new patient slots within two weeks, and the average Ryse patient has over 20 touchpoints with the Ryse team in their first three months.
“The traditional way of treating type 2 diabetes in this country is just not working for the majority of people living with it,” Gurley said. “We started with a blank slate and designed what we believe is the most efficient, effective model for serving people living with type 2 diabetes, helping them manage their care in a way that’s tailored to them. Traditional endocrinology practices are great for many health needs, but I don’t know anyone who would argue it’s the ideal model for the average person struggling with type 2 diabetes.”
On average, Ryse patients see a 2-point decrease in hemoglobin A1c levels within 90 days and beyond, which outpaces traditional or virtual-only solutions by 50 percent or more.
“We built this model specifically to drive clinical outcomes and improve the patient experience, not optimize our revenue in the current payment system, which is riddled with perverse incentives. This partnership with CareFirst is the first time we have been eligible for incentives connected to better patient outcomes, and we are hopeful we can turn that around to serve even more patients.”
This program aligns with the Blue Cross and Blue Shield Association National Health Equity Strategy, which aims to address racial health disparities. As it stands, minority populations are 50 percent more likely to develop diabetes with a higher risk of complications.
Ryse and CareFirst will monitor predetermined, measurable outcomes for members specifically in the National Capital Area monthly. To learn more on how to access Ryse resources, visit rysehealth.com.
About CareFirst BlueCross BlueShield
In its 86th year of service, CareFirst, an independent licensee of the Blue Cross and Blue Shield Association, is a not-for-profit healthcare company which, through its affiliates and subsidiaries, offers a comprehensive portfolio of health insurance products and administrative services to 3.5 million individuals and employers in Maryland, the District of Columbia and Northern Virginia. In 2022, CareFirst invested $24.1 million to improve overall health, and increase the accessibility, affordability, safety and quality of healthcare throughout its market areas. To learn more about CareFirst BlueCross BlueShield, visit our website at www.carefirst.com and our transforming healthcare page at www.carefirst.com/transformation, or follow us on Facebook, Twitter, LinkedIn or Instagram.
About Ryse Health
Ryse Health is an operator of specialty cardiometabolic health clinics custom built for individuals living with complex type 2 diabetes. Its clinical model combines a multidisciplinary team of endocrinologists, dietitians, diabetes educators, behavioral health specialists, and health coaches with advanced technology and engages patients in person at Ryse clinics and virtually. Ryse is accepting new patients referred from primary care and hospital-based physicians as well as patients who self refer.