; Blue Cross And Blue Shield Of Kansas City Announces A Collaborative Value Program To Reimburse Hospitals
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Press Release

Blue Cross And Blue Shield Of Kansas City Announces A Collaborative Value Program To Reimburse Hospitals

April 5, 2012

Kansas City – Blue Cross and Blue Shield of Kansas City (Blue KC), the largest health insurer in the Kansas City area, announced today it is implementing an innovative way to pay hospitals. Blue KC’s collaborative value reimbursement program will partner with Saint Luke’s Health System and focus on collaboration between the patient, provider, hospital and insurance company, where the shared goals of increased quality of care and decreased costs are paramount.  

Buoyed by the success of its Patient Centered Medical Home program, Blue KC expects the collaborative value reimbursement program will offer measurable results and put Kansas City hospitals at the forefront of a new way of thinking about patient care. Growing steadily since its inception in 2009 with 67 primary care physicians, the Patient Centered Medical Home initiative now includes 422 providers and 110,000 patients.

While the Patient Centered Medical Home program relies solely on primary care physicians to manage the care of a defined population, the collaborative value reimbursement program with hospitals and their employed physicians will bring the fully integrated care delivery system to bear on controlling costs and improving quality.  Hospital systems have the added benefit of incorporating specialty care and additional ancillary services like radiology and ambulatory surgical centers in a cohesive team to foster enhanced communication and improved care coordination. 

The core of Blue KC’s collaborative value reimbursement relationships is effective primary care. Some of the most important mechanisms for reducing and slowing the growth in healthcare expenditures are prevention, early diagnosis, chronic disease management and increased care coordination, primarily delivered through primary care practices.

“With the Patient Centered Medical Home initiative, we’ve seen positive results in both outcomes and cost. We’re excited about advancing the ideas and applying them to the integrated delivery system that hospitals provide,” said David Gentile, Blue KC President and Chief Executive Officer. “With the collaborative effort of a hospital’s integrated delivery system, we stand to see even better results in terms of enhanced care, member access and lower costs.” 

Dr. Melinda Estes, President and CEO of Saint Luke’s Health System, echoed this sentiment.  “We are continuously seeking to enhance the quality of services we deliver to the Kansas City community while lowering costs where possible.  Collaborative value reimbursement programs are a vehicle to do just that,” said Dr. Estes.

Saint Luke’s Health Systems is the first such delivery system to be a part of the collaborative value reimbursement program. “The physicians of Saint Luke’s Health System have embraced the Patient Centered Medical Homes practice model and are energized by these new programs from Blue KC,” said Robert Bonney, Senior Vice President of Network Operation and Development, Saint Luke’s Health System.

Blake Williamson, Blue KC Vice President and Chief Medical Officer said, “Patient centered medical homes have shown significant impacts in quality and patient satisfaction both locally and nationally and collaborative value reimbursement programs are going to continue to build on the successes we’ve seen. We are excited to see Saint Luke’s building these critical capabilities.”

The ultimate goal of the new program is to work collaboratively to improve coordination and communication among physicians, and other providers and suppliers, to help improve care while lowering costs.

If all elements go as planned, the agreement with Saint Luke’s Health Systems has the potential to produce meaningful savings over time ranging from  $3 to $10 on a per member per month basis, while offering better outcomes for patients, specifically those dealing with chronic diseases. It also will help both patients and physicians to be more accountable for improved health and lowered costs.

About Blue Cross and Blue Shield of Kansas City
Blue Cross and Blue Shield of Kansas City, the largest not-for-profit health insurer in the state and the only not-for-profit health insurer in Kansas City, has been part of the Kansas City community since 1938. Blue Cross and Blue Shield of Kansas City provides health coverage services to nearly one million residents in the greater Kansas City area and Northwest Missouri. Blue Cross and Blue Shield of Kansas City is an independent licensee of the Blue Cross and Blue Shield Association. For more information on our company, visit our Web site at BlueKC.com. Our mission statement: We will use our role as the area’s leading health insurer to provide affordable access to healthcare and to improve the health and wellness of our members.