Baystate Health and Health New England Remove Barriers to Streamline Access to Care

SPRINGFIELD, Mass.— Baystate Health, with its health plan, Health New England, today announced the Clear Path Pilot Program, a one-year pilot initiative to help eligible patients receive care faster to nearly 1,200 eligible, fully employed Baystate Health providers by reducing prior authorization requirements for more than 800 medical and imaging service codes. Health New England fully funded commercial members and Baystate Health’s employer group members are eligible for participation. The one-year pilot focuses on providing timely, medically necessary care, streamlining processes across Baystate Health’s integrated system, improving health outcomes, and eliminating costs.

“The health care system is mired in outdated, administrative-heavy burdens that result in a fragmented and frustrating experience for patients, physicians and providers,” said Peter D. Banko, President & CEO, Baystate Health. “All too often these processes can lead to unnecessary friction between patient and health plan along with physician and health plan. The Clear Path Pilot Program puts patients and caregivers first, and reflects our renewed focus on access, coordination, outcomes, and the patient and member experience across Baystate Health and Health New England.”

By leveraging the capabilities of Baystate Health, as an integrated health system with a health plan, the Clear Path Pilot Program reduces administrative barriers for eligible patients and their care teams while maintaining clinical oversight, quality standards, and protections that ensure patients receive appropriate care. Direct communication between Baystate Health providers and Health New England, the use of shared clinical and utilization data, joint governance and enhanced care coordination will lead to improved and streamlined access.

“Clear Path is designed to help patients receive medically necessary care more efficiently while preserving the safeguards that protect quality and safety,” said Dean Sanpei, Interim President, Health New England, and Chief Administrative Officer and Chief Strategy Officer, Baystate Health. “By pairing fewer administrative steps for select services with robust data sharing, retrospective review and ongoing clinical oversight, we can evaluate this pilot’s more streamlined approach.”

Baystate Health and Health New England’s integrated capabilities will support close monitoring of access, quality, utilization, member and provider experience, and total cost of care throughout the pilot. As the pilot demonstrates its ability to reduce administrative burden while maintaining quality, supporting care coordination, and responsibly managing utilization and cost, Health New England will be positioned to expand the program to provider organizations that meet eligibility, data-sharing, governance, oversight and accountability requirements, and apply it to other health plan products.