Blue Cross Blue Shield Creates Largest Patient-Focused Care Network
By Christine Kern, contributing writer
Blue Cross Blue Shield Association (BCBSA) has announced the creation of a new patient-focused care network, Blue Distinction Total Care, which integrates care models that emphasize prevention, wellness, disease management, and coordinated care. The new platform is a response to the push by Health and Human Services to transition healthcare from fee-for-service to value-based care models of payment.
In January, HHS Secretary Sylvia Burwell announced measurable goals and a timeline that would move the Medicare program and the healthcare system at large toward a payment system that paid providers based on the quality, rather than the quantity of patient care.
Total Care includes nearly 450 patient-focused care programs with nearly 118,000 medical professionals across 37 states, and is anticipated to expand to more hospitals and professionals in the future. Nearly 13 million Blue Cross and Blue Shield (BCBS) members have access to care through Total Care, with an estimated savings of more than $840 million over traditional payment models annually.
According to a BCBS statement, “BCBS companies around the country have documented reductions in emergency room visits, as well as fewer hospital admissions and readmissions. 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 Total Care program recognizes the need to spend time on prevention, holistic care, and personalized care planning for patients, with an emphasis on healthcare rather than sick care. It fosters strong relationship between healthcare providers and their patients to promote better overall health. Total Care comprises nearly two-thirds of all BCBS patient-focused care programs and includes select ACOs and patient-centered medical homes.
“Blue Cross and Blue Shield companies are leading the transformation to a better health care system that helps people access better, more affordable care. Our programs emphasize prevention, wellness, disease management and better coordinated care while reducing costly duplication and waste in care delivery,” said Trent Haywood, M.D., J.D., chief medical officer for BCBSA. “Through Blue Distinction Total Care, BCBS companies are bringing the most effective, locally-developed, patient-focused care programs to a national level to better serve the needs of national employers and their employees.”
More and more hospitals have begun to embrace value-based payment models, with more planning to make the transition soon, according to research from Kaufman, Hall, & Associates LLC. In one example of this new trend, Health IT Outcomes reported on how Crystal Run Healthcare made the successful transition to value-based reimbursement.