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DELIVERY SYSTEM REFORMS: REWARDING HIGH-QUALITY, WELL-COORDINATED CARE

BCBSA and the Blue Cross and Blue Shield Plans believe that incentives in the healthcare delivery system must be changed to promote better care for patients.  To this end, the Blue System has developed a wide range of innovative initiatives to reward providers for delivering high-quality, well-coordinated care, especially for the increasing number of Americans with chronic illnesses.  Among them:

• Blue Distinction Centers for Specialty Care® identify facilities that meet evidence-based selection criteria and promote efficient, quality care;
• Patient-Centered Medical Homes - with models being tested by most Blue Plans – encourage evidence-based and well-coordinated care and provide incentives for high-quality outcomes and chronic disease management;
• Pay-for-Quality Programs, initiated by many Blue Plans, reimburse providers based on outcomes and quality instead of simply paying for more services; and
• Prevention/Care Coordination Initiatives for Chronic Illnesses improve care through better coordination and management, as well as consumer education and outreach.

As these programs demonstrate, the Blues and other private health plans can quickly innovate to provide high-quality care, benefits and service. 

BCBSA Policies and Positions
BCBSA’s Position on Delivery System Reforms
BCBSA’s Recommendations for Delivery System Reforms

Other Resources
Congressional Testimony by Donald R. Fischer, CMO/SVP of Highmark Blue Cross Blue Shield, on Implementing Best Patient Care Practice

Coalitions
Patient-Centered Primary Care Collaborative