WASHINGTON – Blue Cross and Blue Shield (BCBS) companies’ patient-centered care programs produced an estimated cost savings of more than $1 billion in 2013 through incentives that emphasize prevention, wellness and coordinated care while reducing costly duplication and waste in care delivery. A Blue Cross Blue Shield Association (BCBSA) annual survey showed that BCBS companies increased the medical spending tied to these programs by 9 percent in 2013 compared with 2012.
A new BCBSA report, “Transforming Healthcare Delivery: A Pathway to Affordable, High-Quality Care in America,” released today, identifies four strategies for successfully shifting from the fee-for-service model—which rewards the volume of medical services provided—to one that pays medical professionals for quality care and success in treating patients. These are:
- Change the way doctors and hospitals are paid to provide incentives for delivering higher quality care and improved patient health outcomes.
- Provide doctors and hospitals with the tools and real-time patient data they need to transform their practices.
- Help individuals be active partners in their own healthcare.
- Promote savings and efficiency by targeting services that add cost without adding value, such as unnecessary or duplicative testing.
The breadth of The Blues® programs collectively makes the 37 independent BCBS companies the market leaders in developing and executing these programs. The companies are now directing more than $71 billion in medical spending–one in five dollars annually– through these programs.
BCBS companies around the country have documented reductions in emergency room visits, fewer hospital admissions and readmissions, and reduced hospital infection rates. At the same time, there have been measurable improvements in prevention, including improved cholesterol control, better adherence to best practices for treating diabetes and higher rates of screenings and immunizations.
The BCBSA survey reveals a vast portfolio of 570 locally-developed, patient-centered care programs in 48 states, Washington D.C. and Puerto Rico. The companies have engaged with more than 228,000 physicians and 1,500 hospitals to increase quality and hold the line on healthcare spending. More than 25 million BCBS customers are currently accessing care through these innovative care programs.
“Community by community, BCBS companies are leading the transformation of our healthcare system by emphasizing prevention, wellness, disease management and coordinated care," said Scott Serota, CEO for BCBSA. “We hope that both public and private organizations can learn from our successes and build on them as they move forward.”
The Blue Cross Blue Shield System portfolio includes accountable care organizations, patient-centered medical homes, pay-for-performance programs and episode-based payment programs, all aimed at rewarding quality care that is effective and efficient and that leads to better health for patients.
The programs encourage and support clinicians and hospitals in modernizing their practices and coordinating their patients’ care. They also help people become active partners in their own health through wellness programs, information that helps them manage chronic conditions and resources that help them fully understand the quality and cost of medical services.
In January, the BCBS System launched Blue Distinction Total CareSM (BDTC), a national designation program that recognizes doctors and hospitals for their efforts in coordinating total patient care, while enabling employees of national organizations to access locally-based programs in different markets across the country. Hospitals and physicians in BDTC programs are paid for performance measured by the quality of care delivered and its cost efficiency. BDTC now includes nearly 400 patient-centered care programs in 35 states and the designation will expand to medical facilities in more markets in the coming years.
For more information on Blue Cross and Blue Shield patient-centered care programs, visit http://www.bcbs.com/why-bcbs/pathway-to-better-health/.
View details of Blue Cross and Blue Shield companies’ patient-centered care model results.
About Blue Cross Blue Shield Association
Blue Cross Blue Shield Association is a national federation of 37 independent, community-based and locally operated Blue Cross and Blue Shield companies that collectively provide healthcare coverage for more than 106 million members – one in three Americans. For more information on the Blue Cross Blue Shield Association and its member companies, please visit www.BCBS.com. We encourage you to connect with us on Facebook, check out our videos on YouTube, follow us on Twitter and check out The BCBS Blog for up-to-date information about BCBSA.
About Blue Distinction Total Care
Designation as a Blue Distinction Total CareSM Provider means this Provider has met the established national criteria and has been designated by the local Plan. To find out which services are covered under your policy at any facilities, please call your local Blue Cross and/or Blue Shield Plan; and call your provider before making an appointment, to verify the most current information on its Network participation and Blue Distinction Total Care status. Neither Blue Cross Blue Shield Association nor any of its Licensees are responsible for any damages, losses, or non-covered charges that may result from using Blue Distinction or receiving care from a Blue Distinction or other provider.