Video: Tackling the most complex patient cases to improve lives and make healthcare more affordable

Identifying and addressing the most complex healthcare cases is one of the ways to improve patient outcomes and reduce unnecessary hospital readmissions. Blue Cross Blue Shield Minnesota (BCBS MN) is making a difference for members by simplifying the healthcare journey for those experiencing significant healthcare challenges through a special case management team, the High Complexity Case Unit (HCCU).

How it works:

The HCCU consists of a dedicated cross-functional team of clinicians who identify high risk members who may require more intensive medical and behavioral health services. Launched in 2016, the HCCU has been providing patient-centric care management with the goal of simplifying care among multiple providers across various specialties to streamline care and reduce costs.

Results:

• In 2019, HCCU connected with more than 1,400 members (January-September)
• More than 70% of members eligible for the program are engaged with their case managers, an increase of nearly 12% from 2018
• On average, nearly $25,000 in unnecessary health care costs is eliminated for each member engaged in the program and working with an RN case manager on the HCCU team. Hospital readmissions for BCBS MN members in this group were reduced by an estimated 6%.

The HCCU’s holistic approach to patient care also addresses barriers including housing and food insecurities. Marcy, a registered nurse and case manager with BCBS MN’s HCCU, spent more than a year helping BCBS MN member Antonio, a stroke survivor, navigate complex care issues that extended beyond his health diagnosis.

In this video, see how Marcy initiated an accelerated care plan for Antonio. Today, Antonio calls Marcy his “angel.”

Blue Cross Blue Shield of Minnesota is an independent licensee of the Blue Cross Blue Shield Association, an association of independent, locally operated Blue Cross and Blue Shield companies.