At BlueCross BlueShield of Tennessee our top priority is to make sure our members get the best possible health care at the lowest price. And even before health care reform became law, we were working to develop value-based, cost-saving payment and delivery systems that will help improve efficiency. Here are just a few of the ways we are working with health care providers to improve the delivery of quality, cost-effective care in Tennessee.
- Bundled payments – a reimbursement model that provides a set payment amount for an entire episode of care, rather than separate payments for each component, for common procedures such as hip and knee replacements.
- Accountable care systems – groups of coordinated health care providers (including primary care physicians, hospitals and specialists) who are accountable to their patients and third-party payers for providing appropriate and efficient care at a flat monthly rate, with an incentive to receive a portion of any savings.
- Patient-centered medical homes – a model of care that centers on primary and preventive care of patients and is often used for patients with chronic conditions.
- Reducing gaps in care – developing tools for clinicians to address gaps in care, which can lead to healthier patients and reduce future spending.
These new models will focus on performance measurements and care coordination to ensure that people like you are receiving quality care. They will also shift financial incentives away from the quantity of services to the quality of care provided.
Cost and quality are important to everyone in the health care system. And to make these new models successful, we’re working hand-in-hand with providers (and patients) throughout Tennessee.
Posted in: Health Care Costs 101