Years ago, health insurance companies and physicians had conflicting priorities. Some say the quality of patient care suffered. The issue, of course, was money.
Today, a new model is emerging. Insurers are beginning to invest in patient-care partnerships with doctors, and the early results are staggeringly positive.
Blue Cross and Blue Shield of Louisiana has long been working to perfect this cooperative model. Two years ago, we launched a program to help our network of primary care doctors better manage their patients’ chronic conditions.
Through this program, Quality Blue Primary Care, we offer physicians software, tools and data to track care and transform their practices, putting resources in place so they can concentrate on treating patients. And we pay them for treating chronic conditions effectively.
This is particularly important for Louisiana, where about half of adults have at least one chronic health condition, accounting for up to 70 percent of medical costs.
Specifically, we share claims data combined with the doctor’s data, which allows them to better diagnose and treat their patients. Our nurses provide health coaching and follow-up to the physician’s patients — our customers — to support their care.
This program offers a tremendous opportunity to reverse our state’s historically poor health rankings. Data show that after only one full year, our participating primary care physicians are getting better health results for patients who have the targeted chronic conditions. From January to October 2014, there was a 12 percent improvement in diabetes care, a 28 percent improvement in hypertension care, a 32 percent improvement in vascular disease care and a 69 percent improvement in chronic kidney disease care.
The following data make clear the impact our Quality Blue program can have on health care costs and why we plan to expand this innovative program aggressively.
When a prediabetic person becomes diabetic, the average annual cost of treatment is $6,667.
When a hypertensive person has uncontrolled blood pressure and has a stroke, the average cost to treat that person in the first 90 days is $15,000.
When a vascular disease patient with uncontrolled cholesterol levels has a heart event, the average treatment cost for the first five days is $21,500.
The average annual cost for treating a person with chronic kidney disease is $23,500. If the condition worsens and dialysis is required, the cost jumps to $100,000 a year.
Quality Blue Primary Care demonstrates how insurers and physicians can work together as a team to support our mutual customers. It also shows we have a real opportunity to contain health care costs while improving the health of Louisianians.
To learn more about the Quality Blue Primary Care program, visit bcbsla.com/QBPC, where you can also read our new white paper.
CEO, Blue Cross and Blue Shield of Louisiana