The Blue Cross and Blue Shield Association says any plans for healthcare reform should include incentives to provide quality care.
At a Capitol Hill briefing Tuesday, BCBSA officials told White House and Congressional staffers it is crucial to change incentives in the payment system to reward the delivery of high quality care, as 30 percent of today's healthcare spending is going to care that is ineffective, redundant or inappropriate.
BCBSA has established a nationwide Blue Distinction Designation Program that has so far recognized 800 specialty centers in 42 states for providing quality care based on evidence-based thresholds. BCBSA set standards for recognition in this program in collaboration with healthcare providers and professional organizations, a statement said.
BCBSA President and CEO Scott P. Serota said the Blues are committed to building a healthcare system based on proven clinical outcomes and economic value.
At the briefing Don Fischer, MD, senior vice president and chief medical officer of Highmark, Inc., said the Pennsylvania-based plan uses national evidence-based and preventive care standards for care provided in hospitals and office settings.
"We have had remarkable success in Pennsylvania by working collaboratively with our hospitals and providers," he said.
Blue Cross Blue Shield of Massachusetts has a new program that will focus on linking accountability with quality, according to Robert Mandel, MD, vice president for healthcare services. The Massachusetts Blue will offer incentives for providing "optimal patient outcomes" and work closely with providers to restructure the traditional fee-for-service payment system, he said.
In North Dakota, Blue Cross Blue Shield has focused on patient-centered care based on a medical home model. Jon Rice, MD, senior vice president and chief medical officer for the North Dakota plan, said they saved $1,200 per patient per year in 2006 by reducing emergency room visits for diabetics through well-managed care in the home.
"By focusing on a collaborative approach, the program successfully improved patient outcomes and value," he said.