Blue Cross And Blue Shield Company Initiatives Honored With BlueWorks® Awards For Improving Healthcare

February 27, 2008

The Blue Cross and Blue Shield Association (BCBSA), in collaboration with the Harvard Medical School's Department of Health Care Policy, announced that four Blue Cross and Blue Shield companies are recipients of BlueWorks® awards.

BlueWorks is a program developed by BCBSA in collaboration with the Harvard Medical School's Department of Health Care Policy.  Department researchers evaluate Blue Cross and Blue Shield company programs on innovation, efficacy, robust design and the potential for replication.  Since 2004, Harvard Medical School's Department of Health Care Policy has recommended 44 Blue Cross and Blue Shield company programs as BlueWorks winners. 

"Blue Cross and Blue Shield companies are committed to meeting the evolving healthcare needs of employers, providers and consumers. These latest BlueWorks winning programs are excellent examples of how the Blues are reshaping the healthcare landscape in America by becoming active partners in the health and wellness of our more than 100 million members," said Scott P. Serota, BCBSA president and CEO.

The BlueWorks winners reflect the commitment of Blue Cross and Blue Shield companies to improve the quality and value of healthcare in the United States by encouraging research on what works; changing incentives to promote better care; empowering consumers and providers; promoting health and wellness; and expanding coverage through public-private coverage solutions.  The winning programs align with these five key areas that were recently detailed in BCBSA's new report "The Pathway to Covering America."  The report can be viewed at www.bcbs.com/issues/uninsured/pathway-to-covering-america/.

"Each year, we are pleased to learn that Blue Cross and Blue Shield companies are consistently improving and designing initiatives that provide positive results and that can be replicated in other communities," said Barbara McNeil, M.D., Ph.D., head of the Department of Health Care Policy, Harvard Medical School.

The following BlueWorks winning programs showcase how Blue Cross and Blue Shield companies from around the country are pioneering programs with proven outcomes:

Reducing Employee Disability

The National Center for Health Statistics estimates that nearly 600 million work days were lost in 2003 due to employee disability.  Getting an injured employee back to work as soon as possible is critically important, as the longer an employee remains off the job the less likely they are to ever return.  Recognizing that employee disability is a serious concern for employers, Blue Cross and Blue Shield of Texas implemented Blue CareLinkSM Integrated Medical and Disability Management Program.  Blue CareLink promotes early identification, proactive intervention and aggressive follow-up to members with medical conditions that could place a member at risk for prolonged disability.  One year after the program's inception, more than half of the enrollees in Blue CareLink returned to work earlier than expected based on national averages for their type of injury.  This resulted in cost savings of more than $6.2 million for employers and minimized loss of wages for the employee.

Reducing Non-Emergency Emergency Room Visits

Blue Cross of California's (BCC) Take Charge of Your Health – Self-Care Initiative, is a nationwide enhancement of BCC's original pilot effort aimed at reducing non-emergent emergency room (ER) visits.  With the focus still on redirecting non-emergency care to a primary care setting, the Self-Care Initiative also includes a strong emphasis on changing behavior and self-care management through the use of education and one-on-one assistance.  After its first year of deployment, the Self-Care Initiative observed a more than 50 percent decrease in ER usage among members enrolled in the program.  The return on investment is significant in terms of decreased ER utilization, improved hospital relations and improvement in access to primary care.

Raising Inner-City Awareness of Cardiovascular Risk Factors

CareFirst BlueCross BlueShield's "Hair, Heart and Health," launched in Baltimore City, Md., in mid-2006, focuses on raising awareness of cardiovascular risk factors among clients of inner-city salons and barbershops.  At least three hair care professionals are trained at each site to provide blood pressure screenings and counseling on the causes and effects of cardiovascular disease and offer ideas on lifestyle changes to help their customers prevent having a heart attack or stroke.  CareFirst's "Hair, Heart and Health" initiative has been embraced by the community.  Eleven shops and salons screened nearly 800 customers in the program's first year – while providing ongoing monitoring to more than 200 known hypertensive patients.  The tremendous success of the program has led to expansion of "Hair, Heart and Health" into Washington, D.C., in late 2007.

Improving Members Healthcare

WellPoint, Inc., the parent company of Anthem Blue Cross and Blue Shield, Blue Cross of California, Blue Cross and Blue Shield of Georgia and Empire Blue Cross and Blue Shield, has developed a Member Health Index (MHI) – a tracking system that incorporates nearly all of its health plans' nearly 35 million members.  The MHI combines more than 40 selected healthcare measures including screening and prevention, care management, clinical outcomes and patient safety.  Using a proprietary calculation developed by a multi-disciplinary team including quality improvement experts, healthcare economists and clinicians, the MHI tracks the health plans' progress toward improving members' health through education, care management and wellness programs.  WellPoint's MHI results can help define opportunities to improve the healthcare experience of its health plans' members.  The goal is to use the MHI and its counterpart, the State Health Index, where WellPoint's health plans work with community and state leaders to design programs that will help address health issues and, in turn, improve the health of millions, to track the company's progress in improving the lives of the people it serves and health in its communities.  WellPoint tasks itself to ensure that MHI improves each year, decreasing the gap between current and target performance by 5 percent each year.