Blue Cross and Blue Shield of Louisiana offers its network providers opportunities to earn recognition, additional payments and other incentives through Quality Blue, a new series of innovative healthcare quality improvement programs.
Quality Blue Primary Care (QBPC) is Blue Cross and Blue Shield of Louisiana's innovative population health and quality improvement program. QBPC is designed to get better outcomes for patients with chronic diseases, support doctors and transform healthcare delivery. To implement QBPC, Blue Cross and Blue Shield of Louisiana is targeting primary care physicians in the network family medicine, internal medicine or general practice that have high volumes of patients who are Blue Cross members with one or more chronic conditions. Quality Blue, which incorporates the standards of the nationally recognized Bridges to Excellence (BTE) program, offers financial incentives to physicians who achieve certified recognition of quality in diabetes care and cardiac care, as well as smart office practices in primary care that produce better outcomes for patients.
QBPC builds on the basic features of Patient-Centered Medical Home to offer an enhanced model for population health, in which providers can focus on improving care quality for their total patient population, not just those who are actively seeking treatment. Blue Cross will offer QBPC practices the technical and clinical support and guidance they need to manage their patients' care in the least disruptive way.
QBPC is launching with a staged rollout planned over two to three years,starting with primary care doctors and clinics treating the highest number of members with chronic health issues, such as diabetes or heart disease. Blue Cross and Blue Shield of Louisiana has partnered with two strategic collaborators, Integrated Medical Processes, L.L.C., and MDdatacor, who will provide support through their expert technology, data mining and practice enhancement capabilities.
Blue Cross will share patient data with practices so both groups can work together to better manage care. A practice coordinator at each provider’s office will work with a Blue Cross quality navigator to get ready for each week’s scheduled office visits and talk about any issues that need to be worked out. Blue Cross Case Management and Disease Management nurses will work with patients between doctor visits to help them follow their care plans. Many Blue Cross members with chronic health issues are enrolled in these programs now, but QBPC will find more patients who can benefit from this extra support. To reward providers for services that enhance the quality of care provided, QBPC pays doctors and clinics a monthly care management fee on top of their usual fee-for-service amount.
Quality Blue programs recognize those physicians who are working in partnership with Blue Cross to transform healthcare systems and improve the way care is delivered to Blue Cross members – their patients – to help them achieve better health outcomes. Click here to learn more.