BlueCross companions with suppliers throughout the state to drive well being care improvements that enhance lives and assist management prices.(Photograph: Ocean/Corbis)
When individuals take into consideration well being care, they often consider docs and nurses, clinics and hospitals. An insurance coverage firm won’t instantly spring to thoughts. However BlueCross BlueShield of Tennessee performs a big position within the state’s health-care system by working with medical companions on methods and pilots aimed toward enhancing the standard and availability of look after Tennesseans.
Higher hospital care, one metropolis at a time
Individuals need reasonably priced well being care that may assist them to get and keep wholesome, so BlueCross joined forces with 4 hospital methods throughout the state in a dedication to offer high-quality medical providers whereas working to include prices. These hospitals created particular groups to assist sufferers discover main care suppliers, use the ER much less typically and scale back the probabilities that somebody handled within the ER should return to the hospital.
Enhancing the standard of end-of-life care
Superior terminal sickness is usually a large problem. Sufferers are sometimes exhausted and in ache, and lots of endure although a number of undesirable or pointless journeys to the hospital or emergency room. BlueCross lately with Nashville’s Aspire Well being to deal with the quality-of-life points that many individuals face on this state of affairs. The partnership supplies 24-hour, personalised medical help for sufferers and households — a brand new care mannequin that improves satisfaction and helps maintain sufferers at house of their remaining days.
Growing choices for high quality, cost-effective care
At the start of 2015, BlueCross and MissionPoint Well being Companions finalized an prolonged five-year strategic partnership settlement, just a few months after unveiling a brand new sort of insurance coverage plan designed to assist members and employers decrease their health-care prices.
Many Center Tennesseans who use MissionPoint — a system that features Saint Thomas suppliers and hospitals — now have extra decisions for care, because of a dual-network plan made obtainable to main corporations within the space. BlueCross members insured underneath the dual-network plan can search care from suppliers in each Blue Community PSM and Blue Community MSM, which incorporates all MissionPoint suppliers. Members with this plan additionally see elevated value financial savings once they select a Community M supplier for his or her care.
Higher outcomes with patient-centered medical houses
Higher care coordination leads to higher well being outcomes for members and decrease general well being care prices — particularly for members with persistent illnesses like diabetes and coronary heart illness. BlueCross has invested in serving to suppliers statewide set up their practices as Affected person-Centered Medical Houses, utilizing a care mannequin that makes it simpler to offer members with high-quality, extremely supportive care.
Why use the PCMH mannequin? As a result of it really works. Research have proven that sufferers who obtain care from PCMHs do not need to be admitted to the hospital as regularly. They do not go to the emergency room as typically and usually tend to have preventive screenings. The outcomes are more healthy sufferers and decrease medical prices, which is why BlueCross goals to have 50 PCMH practices and 450,000 enrolled members all through the state by 2018.
Study extra
Discover out extra about innovation initiatives at . Go to these hyperlinks to study extra about BlueCross’ strategic hospital system companions:
Date: September 3, 2015