Louisiana Healthcare Providers Boost Patient Outcomes, Save Costs with Quality Blue

Feb. 23, 2017

BATON ROUGE, La. – Blue Cross and Blue Shield of Louisiana’s Quality Blue programs continue driving better health results while reining in costs.

Data from the second year of Blue Cross’ Quality Blue Value Partnerships program, in which healthcare providers can earn financial incentives if they successfully improve their patients’ health outcomes and cut spending, shows enrolled providers saved an average of 2.8% of their total healthcare costs during the past year, with the most successful savings reaching 6.25%.

The data also shows that Blue Cross customers who are seeing Quality Blue doctors had overall fewer hospital stays and ER visits, and they were more likely to have recommended preventive care like colorectal cancer screenings or mammograms, than customers seeing other doctors.

“Our Quality Blue programs have gotten great results in a fairly short period of time,” said Dr. Paul Murphree, Blue Cross interim chief medical officer. “Through the strong partnerships we are building with healthcare providers around the state, we have a real opportunity to improve Louisiana’s historically poor health outcomes and hold the line on costs.”

The Quality Blue providers are having regular talks with Blue Cross clinical staff about how to get their mutual customers – Blue Cross members who are their patients – to top-quality, cost-effective care, Murphree added. For example, doctors will ask how much the same test costs at different facilities before referring a patient. “We have a team that helps identify opportunities for both quality and cost, and I believe it is one of the best in the country,” Murphree said.

The seven Accountable Care Organizations (ACOs) enrolled in the program from 2015-2016 were: Baton Rouge Clinic, Baton Rouge General Physicians Group, Gulf South Quality Network, Health Leaders Network, Ochsner Health Network, The Family Doctors and Willis Knighton Physician Network.

These ACOs are treating 185,000 Blue Cross customers, on whose healthcare services the savings were calculated. The ACOs that saved on overall healthcare spending have earned an incentive payment equal to a percentage of those savings.

The main way the ACOs saved money was reducing hospital stays. Hospital care costs a lot more than care in doctor’s offices or clinics. Helping patients avoid hospital stays if they can get the treatment they need elsewhere saves money – for the patient and the ACO.

Overall, the ACOs focused on getting patients to the most appropriate place for care, by:

  • Referring patients to have surgical procedures in outpatient centers when appropriate
  • Doing more patient education about when to go to the ER and when to go to a doctor’s office or urgent care clinic
  • Tightening up referrals to keep patients within the same system for care, which is more coordinated and gives patients easier access
  • Encouraging more patients to see a primary care doctor for most of their health needs
  • Working with patients who have long-term medical needs like heart disease or diabetes to help them stay on top of their health and lower their risks of winding up in the hospital
  • Using advanced lab services for faster diagnosis so doctors can get and use the results faster and avoid admitting patients when not medically necessary

Additional savings came from prescribing more generic drugs and cost-effective medications. Blue Cross let doctors know which drugs on the market are very expensive but have lower-cost alternatives that are just as effective for treatment, so doctors could keep that in mind when writing prescriptions for their patients.

Blue Cross staff gave the ACOs support with technical and analytical help, and Blue Cross paid for access to an online 3M® dashboard that lets them review total cost of care data. This helps the ACOs find ways to use resources effectively, meet quality benchmarks and keep costs in line.

Blue Cross will continue adding more doctors clinics around the state to give more customers the care coordination, health improvement and cost-saving benefits of Quality Blue.

Quality Blue includes other programs like Quality Blue Primary Care, which supports primary care doctors by supplying them with resources like software, data and help from Blue Cross’ own clinical staff. This program has demonstrated improved health results and cost savings, as validated by Tulane University’s School of Public Health.

Blue Cross recently published a white paper outlining the development, implementation and results of its Quality Blue programs.

For more information about Quality Blue, visit bcbsla.com/MyQBPC.

About Blue Cross and Blue Shield of Louisiana
Founded in New Orleans in 1934, Blue Cross and Blue Shield of Louisiana is a tax-paying nonprofit health insurer. We are a private company, mutually owned by our policyholders, with an independent Louisiana Board of Directors and no shareholders. We are an independent licensee of the Blue Cross and Blue Shield Association.

Blue Cross and Blue Shield of Louisiana is committed to improving the health and lives of all Louisianians. With our subsidiaries, HMO Louisiana and Southern National Life, we provide group and individual health insurance plans, life and disability insurance, group voluntary products and administrative services to one out of four Louisiana residents. We’re the only Louisiana insurer that offers plans in every parish. We also provide every customer with comprehensive wellness education, programs and services to help them live healthier lives. Headquartered in Baton Rouge, we have eight regional offices to serve our customers around the state.

Blue Cross and Blue Shield of Louisiana is dedicated to transforming the healthcare industry in Louisiana into one that delivers high-quality health outcomes for our customers with top-notch service at more affordable costs. Our reputation for exceptional service and prompt payments, as well as the hard work of our 200+ in-house doctors, nurses, pharmacists, social workers and dietitians, keeps both customer and provider satisfaction high. Surveys by the Louisiana State Medical Society and the Louisiana Hospital Association consistently rank Blue Cross the best company providers do business with.

Blue Cross is deeply committed to the communities we serve. We invest both time and money in the health and wellbeing of Louisiana children by supporting more than 200 charitable organizations. We invite and encourage all Louisianians to visit our website or talk to us on social media through our online hub at bcbsla.com/social.