Mona Burt , Population Health Management Coordinator Scott Cook , - - PowerPoint PPT Presentation

Mona Burt, Population Health Management Coordinator Scott Cook, Manager Health Analytics April 6, 2017

An Independent Licensee of the Blue Cross and Blue Shield Association.

An Independent Licensee of the Blue Cross and Blue Shield Association.

• Triple Aim
• Local Value-Based Program
• National Value-Based Program

Emphasis on delivering quality health care Making insurance more affordable for our members

Im Improv prove th e the patien e patient experien t experience an ce and d sa sati tisfa sfacti tion Co Cost Qu Quality ty

An Independent Licensee of the Blue Cross and Blue Shield Association.

§ 21 Facilities (5 ACO and 16 PCMH) § 35 Kansas Counties § 54 Provider Clinics § 574 Providers § 190,222 Members in a VBP

§ Monthly Operational Meetings § Vendor Portal – updated monthly § Monthly Reports § Pre-Admission and Discharge (PAD) Messaging § Transitional Care Program § Monthly Scorecard (VIS and PPEs)

Providers are:

§ More proactive in engaging their patient

population

§ More intentional toward targeting patients

who are on 'multiple reports'

§ More aware and refer patients to BCBSKS'

Healthy Options (Disease Management) Program

v16 measures v 6 Domains v Single VIS Score

§ The VIS Score summarizes the level of care for

a provider's attributed population.

§ VIS scores are calculated at both a provider and

clinic level.

§ Monthly Per Member Per Month (PMPM) § Tiered payment based on Clinic's VIS score § Shared Savings

§ Emphasis on Triple Aim § Reduction in Potential Preventable Events

(PPA, PPR, and PPV)

§ Close Gaps in Care

§ Balanced approach § Strategic and goal oriented § Financial awareness

§ Blue Distinction Total Care (BDTC) § National message § Consistent methodology

Mona Burt, Population Health Management Coordinator Scott Cook, Manager Health Analytics April 6, 2017

An Independent Licensee of the Blue Cross and Blue Shield Association.