Posted by Marc Lichtenstein
Trying to transform America’s healthcare system requires more than just great ideas. It needs a set of best practices to utilize in constructing those great ideas to make sure they meet the goals of improving access to high-quality, affordable care.
For more than 80 years, The Blues® have transformed how healthcare is delivered and paid for in communities nationwide. Blue Cross and Blue Shield companies have unique advantages such as being the nation’s first health insurer, their membership size and geographic reach—insuring nearly one in three Americans—and strong presence in local communities with more providers in their network than any other insurer. These advantages form the expertise and insights that are at the core of what we consider the “best practices”, for transforming healthcare:
Improve Care Delivery: Reward doctors who keep their patients well and manage chronic diseases results in healthier patients with less healthcare spending. Blue Plans are leading the nation in advancing highly personalized, coordinated care with more care delivery models, such as Patient-Centered Medical Homes (PCMH) and Accountable Care Organizations (ACO), than any other plan. These two care delivery models are recognized for their ability to improve healthcare quality and lower costs. Blue Plans use medical information and patient data to improve safety, quality and efficiency of care. By drawing on the medical experiences of 100 million people, The Blues are able to analyze which treatments produce the best results, find ways to prevent the most common medical problems, and share those practices with doctors across the country to provide better care to patients.
Empower Consumers: Consumers who have the tools to make smart choices about their health are empowered to be better, more value-conscious healthcare purchasers. Blue Plans engage consumers with easy-to-use-and-access information that helps them find good doctors – wherever they are – the best hospitals for treatment, and the costs of treatment. Online and mobile applications, such as the Blue National Doctor and Hospital Finder and GeoBlue, give consumers access to the best data-driven information available, and the power to make the best healthcare choices.
Offer Better Value: Today’s health insurance customers want products and services that are affordable and tailored to their specific needs. With the most extensive provider networks, a deep understanding of effective approaches to care coordination, the nation’s largest claims database and long history of conducting cost-effectiveness research, Blue Cross and Blue Shield companies have the reach, expertise, flexibility and information to meet these needs both on the local and national level. Blue Cross and Blue Shield companies continue to create the blueprint for better healthcare value through signature initiatives like Blue Distinction. This program designates expert, well-managed specialty care facilities as well as high-performing PCMHs and ACOs. By identifying hospitals and physician practices across the nation that are proven to deliver quality, efficient patient care, The Blues are making it easier for consumers to find the right provider and for customers to build local networks tailored to their specific needs.
Performance-based care that rewards quality outcomes and patient satisfaction is part of a new movement in healthcare. It stems from a patient-centered, rather than a process-driven, approach.
To learn more about our strategies and best practices for transforming America’s healthcare system, download your free copy of “Building Tomorrow’s Healthcare System. The Pathway to High-Quality, Affordable Care in America”.