Building Tomorrow’s Healthcare System
The Pathway to High-Quality, Affordable Care in America
Blue Cross and Blue Shield of Alabama
Blue Cross and Blue Shield of Alabamaworks with the Alabama Hospital Association and more than 60 hospitals statewide through the Alabama Hospital Quality Initiative by providing tools and technology to eliminate healthcare-associated infections (HAIs). The company has underwritten most of the costs for hospitals to acquire technology that reduces HAIs by equipping clinicians with real-time, hospital-wide information that pinpoints actionable opportunities to prevent infection. Hospitals also convene quarterly to share best practices in infection prevention. The statewide initiative is estimated to have saved 316 lives and $7.8 million in 2010 by preventing HAIs in 1,520 patients and avoiding 12,152 hospital days.
CareFirst BlueCross BlueShield
The “Virtual Intensive Care Unit” is a partnership program spearheaded by CareFirst BlueCross BlueShield and Maryland eCare LLC to address a shortage of intensivists, specially trained critical care physicians, to monitor and provide care for 7,000 patients in six intensive care units (ICUs) within five hospitals throughout rural Maryland. The virtual care concept utilizes a central ICU to remotely monitor patients and coordinate care through nurses working at their respective hospitals. Early results of the program demonstrate significantly decreased patient mortality rates, length of stay and turnover of ICU staff. All participating hospitals are consistently meeting or exceeding the program goals to improve care and quality outcomes for rural Maryland residents.
Blue Cross & Blue Shield of Rhode Island
Blue Cross & Blue Shield of Rhode Island’s Quality Counts program, which began in November 2005, is designed to incent primary care physicians (PCPs) to implement multifunctional electronic health record (EHR) systems in their offices. Through the initiative, the company partially funds physician practices’ EHR adoption and provides bonus payments based on mutually agreed-upon quality measures. To date, 80 PCPs have fully implemented EHRs in their practices; those that have been using EHRs for one year or more are required to write e-prescriptions for certain medications at least 60 percent of the time. Quality metrics were selected to reflect providers’ attainment or improvement in immunizations, blood pressure control, cholesterol control and preventive screening exams and are demonstrating positive results to date. For all these measures, Family Medicine and Pediatrics experienced a 44-percent improvement; Women’s Care experienced a 35-percent improvement; and Internal Medicine achieved a 24-percent improvement.
