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Case Study - Population Health Management

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Summary: Blue Cross and Blue Shield of Louisiana developed a population health quality improvement program called Quality Blue Primary Care. The program focuses on management of chronic conditions to improve patient health outcomes and reduce costs. Blue Cross and Blue Shield of Louisiana (BCBSLA) utilizes SPH Analytics' Population Care™ Patient Registry and Population Health solution to help practices identify, manage, and improve the quality of care for their patients as well as reduce costs. Results indicate the program is making a positive impact on chronic disease management with improved health outcomes and lower healthcare costs. Background: The United States is currently facing a serious issue of high healthcare costs and lower quality health outcomes, and this dilemma is even greater for Louisiana than most other states 1 . A significant driver of Louisiana's high healthcare costs and poor health outcomes is the large number of patients with chronic diseases. BCBSLA has a history of working with their physicians and physician practices to improve the health of its patients and members through support services and quality improvement programs. BCBSLA realized the need for a powerful population health tool to drive their quality improvement program. Challenge: As mentioned, the high number of patients with chronic disease conditions is a significant factor in Louisiana's high healthcare costs and poor health outcomes. Furthermore, these problems are naturally expected to increase over time unless effective interventions are developed. Another significant challenge for the plan was that healthcare systems across the continuum of care were not set up to effectively manage the needs of patients with chronic disease conditions. Most physicians, hospitals, practice groups, and health plans have not had the ability to effectively and consistently share patient healthcare information in a systematic or timely manner. Given these factors, the primary challenge facing BCBSLA was to develop a value-based system for sharing information among insurers, physicians, employers, and patients, and working together to identify meaningful actions that would measurably improve the patient's health outcome. 1 United Health Foundation – America's Health Rankings© 2016, Population Health Quality Improvement Program Improves Outcomes and Reduces Costs Case Study TM SPH Population Care

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