On 1 de octubre de 2019, Blue Cross & Blue Shield of Rhode Island (BCBSRI) will launch a new version of its New England Health Plan (NEHP) product called Network Blue New England Options. The new product, which is being launched in response to consumer demand, will feature access to the same high performing regional network as existing NEHP plans and require both a PCP and referrals, but will also include two levels of benefits, with providers assigned based on their cost and quality.

All providers in the Network Blue New England Options network default to the Standard level of benefits, with a select few PCPs, hospitals, and radiologists being selected for the Enhanced level of benefits, which features reduced cost share for the member. The basis for this selection is cost and quality, which is measured in part using BCBSRI’s existing PCP Performance Rating methodology for PCPs, HCAHPs, HAIs, and Leapfrog metrics for hospitals, and cost relative to peers for radiologists.

In addition the local Rhode Island provider network, Network Blue New England Options includes coverage in the rest of New England, excluding Vermont, with the benefit differential also being included in Massachusetts and New Hampshire. BCBSRI intends to periodically update the list of providers in the Standard and Enhanced benefit levels as new information becomes available.