What the Blues are Doing
Identifying and addressing gaps in care
Blue Cross and Blue Shield of Hawaii supports self-monitoring of blood glucose (SMBG) to help address gaps in diabetes care. As part of a comprehensive diabetes care improvement initiative, more than 1,800 members on insulin therapy without persistent SMBG, along with their prescribing physicians, were included in an educational intervention program to promote regular monitoring. This targeted intervention was associated with a nearly 14-percent increase in the proportion of members on insulin therapy who perform SMBG. The intervention resulted in increased SMBG compliance from 50.5 percent to 65.7 percent among Medicaid members; 58.1 percent to 67.8 percent among Medicare members; and 67.5 percent to 75.6 percent among commercial members.
Blue Cross and Blue Shield of Florida launched an initiative that focuses on African-American and Hispanic members with type 2 diabetes who had at least two identified gaps in care, such as a retinal eye exam and Hemoglobin A1c testing. If they were missing at least two recommended screenings, they were targeted for further interventions using a three-pronged approach: physician notification, member outreach with information on care gaps and follow-up calls by nurse educators.
Prioritizing healthy lifestyles
Louisiana 2 Step is Blue Cross and Blue Shield of Louisiana’s flagship free health and wellness program available to both members and non-members. The program was developed to address one of the state’s main health challenges - obesity - which is not only linked to a variety of other diseases, but also is directly tied to lifestyle choices. At the program’s core is teaching Louisianans how two small steps, eating right and moving more, can greatly impact their health. More than 17,700 Louisianans across the state already have taken the first step by becoming registered members of the program. Registered members have access to an interactive website featuring healthy food recommendations, activity and walking logs, weight tracker, calorie counter and personal virtual coach. In 2011 alone, the site received more than 2.3 million visits.
Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, as well as Blue Cross and Blue Shield of Texas (under the operation of Health Care Services Corporation) are partnering and investing with local nonprofit organizations to develop sustainable, measurable programs that will build healthier communities for children and their families. Healthy Kids, Healthy Families is a three-year initiative designed to improve the health status of at least 1 million children by focusing on four areas: nutrition education, promoting physical activity, preventing and managing disease and supporting safe environments. The initiative will focus on engaging children and their families to help them understand the importance of nutritious food, raise their level of physical activity, encourage safe play and increase immunizations. In 2011, Healthy Kids, Healthy Families expects to provide more than 150,000 immunizations through a unique mobile van program, encourage children to exercise by building safe places to play, and offer entertaining nutrition education to the schools and kitchen tables of 125,000 students.
Blue Cross and Blue Shield of Kansas City’s A Healthier You represents workplace wellness programs that engage employees in positive behavior change to improve their health status and avoid the impact of chronic disease. A Healthier You is a comprehensive, customizable and turnkey program for employers, including a workplace wellness audit and an employee health event, consisting of biometric screenings, a Health Risk Assessment (HRA) and nurse consultation. To support continual behavioral change, incentive programs, lifestyle coaching, and webinar and onsite health education classes are offered. With this program, the medical trend was reduced by more than 30 percent compared with the national trend.
Blue Cross and Blue Shield companies established the National Walk@Lunch Day to help people incorporate physical activity into their day by encouraging them to walk at lunch. National Walk@Lunch Day is a component of WalkingWorks®, a Blue company program developed in 2002 with the President’s Council on Physical Fitness and Sports. Nationwide in 2011, hundreds of companies, schools, organizations, state and local governments hosted or participated in the fifth annual National Walk@Lunch Day events.
Combating obesity by encouraging healthy eating
Blue Cross Blue Shield of Delaware is an active participant in Delaware Partners to Promote Healthy Eating and Active Living (HEAL), that is working to prevent obesity through promoting healthy eating and increasing physical activity. This statewide coalition of 70 organizations and 200 individuals focuses on policy, environmental and systems changes to impact the issue. Delaware was listed in a 2011 Gallup Poll as the second heaviest state in the U.S. Research indicates that healthy diet and physical activity are important behaviors in controlling chronic diseases that are the leading causes of death in Delaware: heart disease, diabetes and select types of cancer.
The Blue Cross and Blue Shield Association has rolled out a national Pediatric Obesity and Diabetes Prevention Program to help reduce childhood obesity and prevent future cases of diabetes. In collaboration with the American Diabetes Association and the American Academy of Pediatrics, as well as five Blue companies, the Good Health Club Physician Toolkit was developed to provide educational and behavior-changing tools to share with patients and parents. The toolkits have been distributed to more than 15,000 pediatric and family physician practices across the country, and are available on BCBS.com in English and Spanish. A survey of physicians showed that since receiving the Good Health Club toolkit, 72 percent of respondents discuss this issue with patients more often, and 77 percent found the physician materials effective. Additionally, as part of overall efforts to reduce childhood obesity, BCBSA and several Blue Cross and Blue Shield companies are involved in ongoing discussions with the Partnership for a Healthier America, the private sector counterpart to first lady Michelle Obama’s “Let’s Move!” campaign.
Advocating healthy pregnancies and safe deliveries
Anthem Blue Cross and Blue Shield partners with the Commonwealth of Virginia for a benefit-based incentive program to encourage pregnant women to enroll in maternity management. Current research demonstrates that pregnancy complications are increasing. To reverse this trend, Anthem Blue Cross and Blue Shield collaborated with the Commonwealth of Virginia to conduct a year-long pilot of a maternity management program to support prenatal and postpartum care with Virginia state employees. A financial incentive offered to employees resulted in increased enrollment in the maternity management program. There is substantial evidence that optimal prenatal care offers maternal and infant health benefits by supporting optimal pregnancy health, mitigating high-risk behaviors, providing entry into the healthcare system for both mother and infant and monitoring appropriate resources.
