A Blue Cross and Blue Shield of Louisiana program that rewards physicians for keeping patients healthy already has shown major improvements for people with chronic, and costly, conditions, Chief Medical Officer David Carmouche said.
Diabetes care, which includes controlling blood sugar levels, blood pressure, cholesterol and smoking, improved 12 percent, Carmouche said. Vascular disease care, which includes people not smoking, taking aspirin and cholesterol-lowering drugs and controlling their blood pressure, improved by 32 percent. Kidney disease management, which includes taking drugs shown to slow the progress of kidney disease, improved by 69 percent.
The Quality Blue program’s results were among the highlights Wednesday of The Atlantic’s “Inventing the Future of Health” town hall. The meeting covered a wide range of health care topics and discussions, including devices that can help patients monitor their blood pressure and avoid doctor’s offices; how best to get people to make healthier lifestyle choices — incentives and support not lectures or government intervention — and what experts would change if they could. Blue Cross sponsored the meeting, attended by about 200 people.
Warner Thomas, president and chief executive officer of Ochsner Health System, said he would change the payment system from fee-for-service to global payments, where providers receive a flat fee for taking care of patients for a year.
Thomas said he also would add a personal responsibility requirement.
Ochsner has 16,000 employees and pays $70 million a year for health benefits, Thomas said. About 80 percent of employees participate in the company’s wellness program, and 40 percent to 50 percent of participants earn incentives that lower their health insurance premiums by as much as $3,000 a year.
The employees who earn the incentives are spread evenly throughout the health spectrum, from those with chronic conditions to those without health issues, he said. The incentives aren’t concentrated among the healthiest workers.
Thomas said changing people’s behavior or lifestyle choices is a problem the private sector, employers and insurers, will have to solve.
Janet Wright, executive director of Million Hearts, said while Blue Cross’s results are amazing, they are among the pockets of high performance in the industry.
Million Hearts is a joint initiative of the federal Centers for Disease Control and Prevention and the Centers for Medicare and Medicaid Services. Launched in 2012, the program’s goal is to prevent a million heart attacks and strokes by 2017.
Wright said apps and biofeedback devices can help people manage their blood pressure, sending the data to the person’s electronic health record, allowing their doctors to monitor the results.
Some diabetics test their blood sugar on a daily basis. People can do the same for their blood pressure, she said.