Chicago – Today Blue Cross Blue Shield Association (BCBSA) released a new edition of its Blue Cross Blue Shield Health Index^SM – a first-of-its-kind measurement of health for nearly every county in America. The BCBS Health Index encompasses more than 200 conditions that impact health and identifies those health conditions with the greatest impact on the commercially insured population.

This year’s BCBS Health Index scored the nation at .915 on a scale that ranges from 0 to 1.0. The national score shows the commercially insured population is living at 91.5 percent of its optimum health. States with the highest health index score include California, Colorado, Montana and Utah at .94. States with the lowest health score include Alabama at .88 and Rhode Island, Florida and Maryland at .89.

The upgraded BCBS Health Index is powered by de-identified medical claims data from more than 41 million commercially insured members of BCBS companies. The interactive website allows people to measure the overall health and identify the top 10 conditions that negatively impact health at the state and county levels. New sorting functions also allow users to better compare the health of communities across the country.

According to the BCBS Health Index, the top 10 conditions nationally, causing approximately 58 percent of commercially insured Americans’ overall reduction in health, include:

1. hypertension
2. major depression
3. high cholesterol
4. coronary artery disease
5. type 2 diabetes
6. substance use disorder
7. alcohol use disorder
8. chronic obstructive pulmonary disease
9. psychotic disorders
10. ulcerative colitis/Crohn’s disease

The 10 conditions were also the most impactful the previous year. However, increasing prevalence for top five conditions has further secured their position at the top of the rankings, while substance use disorder, due in large part to the opioid crisis, has replaced alcohol use disorder in the sixth position.

“The upgraded BCBS Health Index boasts enhanced usability and functionality that will help researchers, local health officials and policymakers better measure the health of local communities and benchmark them against nearby or similar communities across the country,” said Maureen Sullivan, chief strategy and innovation officer for BCBSA. “The Index uses the most recent available medical claims data to bring critical health insights and help further focus efforts to improve communities’ health.”

As a comprehensive measurement of actual healthcare experiences, the BCBS Health Index was designed in 2015 to support national and local discussions about how to improve American health policy and practice. It quantifies how more than 200 common diseases and condition categories affect overall health and wellness by assigning each state and 98 percent of counties a health impact measure between 0 and 1, designating the proportion of optimal health reached by the  commercially insured population living in each region. Each state and county’s BCBS Health Index score as well as the top 10 conditions impacting that score, can be found at www.bcbs.com/bcbs-health-index.

BCBSA has also used the BCBS Health Index to provide an infographic presentation about hypertension, which has increased in prevalence and impact to varying degrees across  America, but (due to increases in generic drug use) cost less to treat in 2016 compared to 2014. To view more hypertension insights, visit https://www.bcbs.com/the-health-of-america/infographics/the-impact-of-hypertension-high-blood-pressure-commercially

For additional information regarding the BCBS Health Index, please visit https://www.bcbs.com/the-health-of-america/health-index/national-health-index

BCBS Health Index Methodology
The BCBS Health Index is informed by data from Blue Cross Blue Shield Axis^®, the BCBS companies’ industry-leading data capability. It is also a result of collaboration with Blue Health Intelligence®, which provided analytical support, and consultation with the Institute for Health Metrics and Evaluation, an independent global health research center at the University of Washington in Seattle, that helped BCBS in defining condition categories and measuring their disabling affects.

Using blinded claims data from more than 41 million commercially insured members of BCBS companies, ICD-9 diagnoses were mapped to over 200 health condition categories. The impact of each condition was determined based on the years lost due to the risk of premature death and the disabling effects of illness or disease. These years of life lost were subtracted from the optimum life expectancy (OLE) of a given member with no health conditions and then divided by that same OLE to get an estimate of health between 0 and 1 with 1 corresponding to optimal health, defined as the absence of any currently known conditions or risks associated with adverse health impacts.  A value less than one represents the proportion of future healthy life for that member based on his or her diagnosed condition(s). These individual level estimates are then aggregated to create a health score for the population. The formal calculation is [OLE – (Mortality + Disability)] / OLE, where “OLE” is a person’s optimum life expectancy derived from an actuarial life table, “mortality”  is “years of life lost” due to risk of premature death, and “disability” is years of living with a disability.