A Blue Cross and Blue Shield of Louisiana program that emphasizes getting chronic diseases under control cut costs by $25 per patient per month during the past two years, and even greater savings lie ahead.
During the first nine months of 2015, family doctors in the Quality Blue Primary Care program notched a 25 percent improvement in diabetes care, 31 percent in high blood pressure care, 40 percent in vascular disease care and 69 percent in kidney disease care, the company said. In “people measures” that means more than 5,000 patients with high blood pressure lowered their numbers to a healthy level, said Dr. Paul Murphree, Blue Cross medical director.
“I tell people we saved the equivalent of the town of Port Allen,” Murphree said.
In addition, more than 130 diabetes patients got their blood pressure and sugar levels to a healthy range, more than 70 vascular disease patients returned to optimal levels and more than 530 kidney disease patients got their kidney function levels under control, Murphree said.
The Quality Blue program, launched in 2013, rewards physicians for meeting quality measures that help keep patients healthy. The program targets the chronically ill, whose health care costs are much higher.
“Chronic illnesses affect more than half of Louisianians and account for almost 70 percent of health care expenses each year,” said Mike Reitz, Blue Cross president and chief executive officer. “Quality Blue is our answer to help people become and stay healthy, which keeps their out-of-pocket costs down.”
The already high health care costs for the chronically ill escalate rapidly when their conditions worsen. For example, if a person with chronic kidney disease requires dialysis, treatment costs quadruple to $100,000 a year. When a prediabetic person becomes diabetic, the average cost per year is about $6,700.
Quality Blue doctors are rewarded for meeting quality measures, including making sure patients take their medication, follow treatment plans and make regular visits to their doctors. Participating in the program so far are 656 primary care physicians and more than 180,000 Blue Cross members, roughly 68,000 of them with a chronic disease. Blue Cross has paid those physicians more than $8.5 million in care management fees.
Murphree said the program already has achieved the “triple aim” of better care, better health and lower costs.
Blue Cross hired Lizheng Shi, director of health systems analytics research at Tulane University, to validate its results.
Blue Cross members with Quality Blue doctors have lower monthly health care costs and fewer hospital stays and see their primary care doctors more often than other patients.
“I feel comfortable this program is going to deliver a greater success in the coming years,” Shi said.
The $25 savings per patient per month is a conservative figure, with the biggest savings and benefits accruing to patients with chronic conditions, Shi said.
Follow Ted Griggs on Twitter, @tedgriggsbr.