Collaborating to transform healthcare: Higher quality and patient satisfaction at lower cost

The next time somebody asks me what Regence BlueCross BlueShield and Regence BlueShield are doing to improve quality of care and lower healthcare spending, I have some great proof points to share.

We partnered with six hospitals and medical groups across our four-state market around general population health and, from January 2013 to now, achieved measurably higher quality scores and patient satisfaction.

The gold standard for quality measures is Healthcare Effectiveness Data and Information Set (HEDIS). More than 90 percent of health plans in the country use it to gauge key aspects of care quality and service. By supporting our provider partners, we helped them exceed national HEDIS benchmarks in many areas, while earning patient satisfaction scores above 85 percent.

At Central Utah Clinic, for example, Regence BlueCross BlueShield of Utah partnered with the clinic to lower healthcare spending while improving quality by changing the way we reimburse providers. We used an innovative payment model called Total Cost of Care with this group of independent physicians across the state. We shared key patient and cost data that helped them improve care and, in just one year, to avoid spending nearly $1 million.

And patient satisfaction scores rose dramatically, making this a triple win: higher quality, less cost and satisfied patients. Clinic and Regence BlueCross BlueShield of Utah officials testified before state lawmakers that this collaborative care model works, and we hope to expand it in Utah.

Regence BlueCross BlueShield and Regence BlueShield were early adopters of patient-centered medical homes, one of several kinds of collaborative care agreements. They all focus on paying providers differently to improve quality, achieve better patient outcomes and curb unneeded spending. We call our collaborative care program Regence HealthAdvance.

Today, Regence BlueCross BlueShield and Regence BlueShield have accountable health network agreements with 50 providers across the four states where we operate, with more than 160,000 members receiving care from doctors and hospitals fully engaged in coordinated, high-quality care.  

Transforming health care means changing the way things are done. Our white paper tells about more ways we are Advancing High Quality, Affordable Care.