From Smart Bodies To Statin Therapy, Blue Cross And Blue Shield Companies Honored For Helping Consumers Manage Their Healthcare
October 6, 2008
CHICAGO – The Blue Cross and Blue Shield Association (BCBSA), in collaboration with the Harvard Medical School Department of Health Care Policy, today recognized four ground-breaking Blue Cross and Blue Shield company initiatives for their innovative and successful approaches to improving health and wellness for consumers. These programs coordinate care for children with special healthcare needs, address racial and ethnic disparities in healthcare, enhance statin therapy efficiency, and encourage children to adopt healthy lifestyles.
The programs were recognized as BlueWorks® winners – a unique collaboration between BCBSA and the Harvard Medical School Department of Health Care Policy, through which Harvard researchers evaluate and select Blue Cross and Blue Shield companies' local programs for recognition based on their innovation, efficacy, robust design, and potential for replication. Collaborating with Harvard to evaluate this year's winners were Edward P. Zimmerman, MS, department director, American Academy of Pediatrics; Yul Ejnes, MD, FACP, American College of Physicians; and Leonard Lichtenfeld, MD, FACP, deputy chief medical officer, American Cancer Society.
Since the inception of BlueWorks in 2004, Harvard has recognized 45 programs of Blue Cross and Blue Shield companies for their innovative work to help consumers better manage their healthcare choices.
"Harvard is pleased to recognize the Blue Cross and Blue Shield companies for their innovative programs to provide consumers with the tools they need to make better, more informed healthcare decisions," said Barbara J. McNeil, MD, Ph.D., head of the Department of Health Care Policy, Harvard Medical School. "These efforts are helping to improve the quality, value, and access to healthcare, while enabling consumers to become more engaged in their health and wellness."
The four BlueWorks programs that were recognized for their innovation and success are:
- Caring Program: Care Coordination for Children with Special Healthcare Needs (Highmark Blue Shield's Caring Foundation, Pennsylvania)
- Applications of Indirect Estimation of Race/Ethnicity Data in Health Plan Activities (Anthem Blue Cross, California)
- Enhancing Statin Therapy Efficiency (Blue Cross and Blue Shield of Texas)
- Smart Bodies: Building Healthy Bodies and Active Minds (Blue Cross and Blue Shield of Louisiana Foundation)
"These pioneering programs should be applauded for their efforts to improve the quality of healthcare for consumers," said Scott P. Serota, BCBSA president and CEO. "They are prime examples of the work that Blue Cross and Blue Shield companies are doing to drive health and wellness and make managing healthcare choices easier for consumers."
Children with Special Healthcare Needs (Highmark Blue Shield's Caring Foundation, Pennsylvania)
Parents and caregivers of children with special healthcare needs must often navigate a maze of services and providers to ensure that their children receive appropriate care. Recognizing the enormous financial and emotional burden of this system, the Highmark Blue Shield's Caring Foundation developed the Caring Program. Through its use of community-based nurse care coordinators who engage in home visits and offer ongoing support to families, the program provides communication, coordination, and collaboration among systems. As a result, these children have experienced 50 percent fewer inpatient hospitalizations, and families have enjoyed an estimated cost savings of $334/year.
Racial Disparities in Healthcare (Anthem Blue Cross, California)
Problems of racial and ethnic disparities in healthcare persist in the United States. To better target the healthcare needs of underserved populations, Anthem Blue Cross (California) designed a program to indirectly determine the race and ethnicity of its members, using a combination of name analyses and addresses geocoded with census data. The information allows Anthem to identify underserved members so that it can provide them with culturally and linguistically appropriate screening and health-education materials and other targeted quality-improvement and disease-management initiatives based on race and ethnicity.
Statin Therapy Efficiency (Blue Cross and Blue Shield of Texas)
For people with high cholesterol levels, following a prescribed regimen of statin drugs can help lower the risk of a heart attack or other serious cardiac events. To increase the utilization of statins by members who have been prescribed the drugs but are not adhering to their prescriptions, Blue Cross and Blue Shield of Texas notifies the patients' physicians of the nonadherence and urges the doctors to follow up. The program has produced a significant increase in statin use among target members, who are three times more compliant with statin therapy than previously. In addition to increasing statin use, the program improves economic efficiency through a pharmacy benefit step therapy plan that discourages the use of expensive brand-name statins when less-expensive, generic versions will work equally well for the patients. The rise in statin utilization has been more than offset by the increased use of generic forms of the medications.
Healthy Behaviors for Children (Blue Cross and Blue Shield of Louisiana Foundation)
The startling increase in childhood obesity is a major public health concern. Obese children are likely to become obese adults, which increases the likelihood of their suffering from chronic diseases, including Type 2 diabetes. In response, Blue Cross and Blue Shield of Louisiana Foundation designed the Smart Bodies program, which targets elementary-school children and aims to promote lifelong healthy eating patterns and a physically active lifestyle. Through the program, children increase their basic knowledge of nutrition, learn the importance of physical activity, and increase their intake of fruits and vegetables. In 2007, 89 schools in 32 parishes, serving more than 35,000 students statewide, participated in the Smart Bodies program. Research reveals that students who have taken part in the program have increased knowledge about healthy behaviors, engaged in more physical activity, and maintained healthy weight levels.
A BlueWorks Honorable Mention was also recognized:
Smooth Transition from the Hospital to Home (Blue Cross and Blue Shield of Massachusetts)
The transition from hospitalization to a home setting is increasingly recognized as having significant risks that can result in readmission to the hospital and increased medical expenses. In response, Blue Cross and Blue Shield of Massachusetts developed the Aftercare Program, through which case managers initiate calls to identified members within two days of discharge from the hospital, in order to assess their condition at home, reinforce discharge instructions and address self-management strategies. Preliminary results show a reduction of readmission rates in targeted hospitals of 25 percent and initial savings of $4.4 million. Member satisfaction surveys also report that 95 percent of members surveyed were satisfied with the support that they received through the program.
"Each BlueWorks program promotes a better understanding of the issue at hand and improves the effectiveness of healthcare for the consumer and the healthcare system as a whole," said Harvard's Dr. McNeil. "BlueWorks exemplifies the ways Blue Cross and Blue Shield companies are responding to needs in the current healthcare system with original programs that are showing remarkable impact."
For more information about these Harvard-recognized programs that have been awarded the BlueWorks distinction, please visit http://www.bcbs.com/innovations/blueworks/.
The Blue Cross and Blue Shield Association is made up of 39 independent, locally operated Blue Cross and Blue Shield companies that collectively provide healthcare coverage for nearly 102 million Americans. For more information on the Blue Cross and Blue Shield Association and its member companies, please visit www.BCBS.com.
