Community Health: A Health Plan's Contribution


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Blue Cross of California

This program is notable for utilizing simple, readily available claims data to support collaborative public health research. Other Plans might find opportunities to participate in research addressing the unique health concerns of their Plan population. In this way, health plans can be a driving force in mitigating factors that negatively impact member health rather than confining themselves to treating the problem after it happened.

Program Elements

  • In 2003, Blue Cross of California State Sponsored Business (BCCSSB) saw an alarming rise in asthma-related emergency room visits in Fresno County. Twenty percent of BCCSSB's members with asthma lived there, while emergency room use increased nearly 44 percent since the previous year.

  • BCCSSB joined health care leaders, local officials, public health agencies, academic researchers and scientists, physicians, and clinicians, to form the Valley Air Quality Committee. BCCSSB then shared its health claims data to help identify the correlation between local poor air quality and asthma prevalence rates.

  • BCCSSB and the Committee created a state of the art center to identify and promote best practices for asthma care and help alleviate some of its envi­ronmental triggers.

  • BCCSSB partnered with a local hospital and community agencies to sup­port a Fresno-specific asthma program, which includes better tracking of acute asthma episodes during adverse events, comprehensive asthma education, a provider referral system, and implementation of an air quality flag program in schools.

  • In addition, a BCCSSB Health Promotion Specialist was appointed to con­duct local asthma-related outreach and spearhead educational community activities.

Program Results

  • Patients completing the Fresno–specific asthma program decreased asthma-related hospital use by 60 percent, and their average asthma-related hospital stay decreased by a day. 

  • These patients also decreased their asthma-related emergency department use by 50 percent, with a 25 percent decrease in emergency department time. 

  • Even patients who didn't complete the full program decreased asthma-related hospital use by 15 percent and decreased asthma-related emergency department use by 32 percent.

Contact

John P. Monahan, President, Blue Cross of California State Sponsored Programs, 805-384-3511, john.monahan@wellpoint.com

 


 


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