Quality in Practice: The BCBS Blue Distinction Program Iowa Health Buyers Alliance Annual Conference

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Blue Cross and Blue Shield Association. A national alliance of 39 free, group based and privately worked Blue Cross and Blue Shield organizations Collectively we give human services scope to

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Quality in Practice: The BCBS Blue Distinction ® Program Iowa Health Buyers Alliance Annual Conference Robert Krause, Director National Labor Office Blue Cross and Blue Shield Association

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Blue Cross and Blue Shield Association A national organization of 39 autonomous, group based and privately worked Blue Cross and Blue Shield organizations Collectively we give medicinal services scope for more than 102 million people – 1 in 3 Americans For more data, visit www.BCBS.com

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Mission The mission of the National Labor Office (NLO) is to position the Blues as Labor's social insurance accomplice of decision.

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Mission Marketing devices Database Education Conferences New human services items Affordable and open social insurance Plans Organized Labor

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Our Charge The National Labor Office speaks to the Blue Cross and Blue Shield System with sorted out work for a definitive reason for obtaining and holding contracts for Blue Cross and Blue Shield Plans

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NLO Sponsor Plans – Voluntary Arkansas BCBS Alabama BCBS BS of California Anthem/Wellpoint, Inc.(14 states) Empire BC – East Region BC of California – West Region BCBS of Delaware BCBS of Florida BCBS of Illinois BCBS of Massachusetts BCBS of Michigan BCBS of Minnesota BCBS of Montana BCBS of Nebraska Wellmark BCBS Regence BCBS Excellus BCBS Western New York BCBS CareFirst BCBS Horizon BCBS Premera Blue Cross BCBS of Oklahoma Capital BC Independence BC Highmark BCBS of Rhode Island BCBS of South Carolina BCBS of Tennessee Mountain State BCBS HMSA - Hawaii

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NLO Governance Structure NLO Board of Directors Executive Committee Labor Advisory Committee (counting LAC Liaison to the Board) Market Research Distribution Channel/Partners Education and Training Strategic Alliance Early Retiree/VEBA Revenue Labor Prospects National Labor College Plan Market Survey Blue Labor Basics Labor Certification Program

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Blue Assets and Programs

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 ®  Blue Assets and Programs: Maximizing the Value of Your Customer's Healthcare Dollar Your Customer's Critical Healthcare Needs The Strength that The Blues ® Deliver Target medicinal services dollars Better general wellbeing results and quantifiably bring down costs Increasing part wellbeing engagement at the worksite

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® Better Outcomes and Better Value for Specialty Care Evidence-based determination criteria created as a team with master clinicians and driving proficient associations Broad, comprehensive extension permits quality decisions in four claims to fame for your individuals across the nation (with additionally coming) Simplified part coordinated get to limits requirement for business contribution Results in quantifiably better general wellbeing results and lower costs Provides a quality-based, financially savvy implies for adaptable advantage outline Quality-based assignment for offices with better general results for high cost, high fluctuation wellbeing conditions Note: Designation as Blue Distinction Centers implies that these offices' general understanding and total information met target criteria built up in a joint effort with master clinicians' and driving proficient associations' suggestions. Singular results may shift.

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® Better Outcomes and Better Value for Specialty Care Evidence-based determination criteria created in a joint effort with master clinicians and driving proficient associations Bariatric Surgery Cardiac Care American Society for Metabolic & Bariatric Surgery (ASMBS) Surgical Review Corporation (SRC) American College of Cardiology (ACC) Society of Thoracic Surgeons (STS) Complex & Rare Cancers Transplants Center for International Blood and Marrow Transplant Research (CIBMTR) Scientific Registry of Transplant Recipients (SRTR) Foundation for the Accreditation of Cellular Therapy (FACT) National Comprehensive Cancer Network (NCCN) Criteria are straightforward, accessible to the general population on BCBS.com These associations have given data and information, yet don't formally embrace the Blue Distinction Centers program.

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® WA ME VT ND MT Blue Distinction Centers for Cardiac Care ® NH MN OR NY MA WI SD ID RI MI PA WY CT IA NJ OH NE IN DE IL NV WV MD VA UT CO KY CA KS MO NC Blue Distinction Centers for Bariatric Surgery ® TN SC OK AZ AR NM AL GA MS TX LA FL AK Blue Distinction Centers for Transplants ® HI PR Blue Distinction Centers Complex and Rare Cancers SM Better Outcomes and Better Value for Specialty Care Broad, comprehensive extension permits quality decisions in four claims to fame for your individuals across the country More than 800 Designations crosswise over 45 states We will grow strength regions and increment the quantity of Blue Distinction assigned offices

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® Better Outcomes and Better Value for Specialty Care Simplified part coordinated get to limits requirement for boss inclusion individuals can undoubtedly take in more about Blue Distinction with a tick of a mouse Memorial Hospital 324 W. Fundamental Southpaw, MI 32012 (313) 777-6329 DRAFT St. Joseph's Hospital 123 Beach St. Lakeview, MI 32779 (313) 777-1234 National Doctor & Hospital Finder empowers doctor's facility examinations in view of Blue Distinction status Lake County Medical Center 5734 First Ave. Quinipshaw, MI 32968 (313) 723-5681 North Central Hospital 1 North Central Blvd. Pikesville, MI 32553 (316) 878-5885

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® Better Outcomes and Better Value for Specialty Care Results in quantifiably better general wellbeing results… Cumulative Readmissions (0-90 Days) 5% 11% Coronary Artery Bypass Graft Angioplasty (CABG) (PCI) Other BDC Source: Based on cases information from BlueCross BlueShield Plans in eleven states

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® Better Outcomes and Better Value for Specialty Care ... also, quantifiably bring down costs Average Cost Savings per Procedure (1) (per 90-day scene) Average Number of Procedures every Year (2) (per 5,000 part gather) Potential Savings every Year $65,512 Procedure: CABG 8.3 x $7,893 = $30,996 Procedure: Angioplasty 21.6 x = $1,435 Assumes individuals are not at present using Blue Distinction Centers for these methodology. Source: (1) Based on cases information from BlueCross BlueShield Plans in eleven states , in view of 90-day scene (2 ) American Heart Association: Heart Disease and Stroke Statistics—2008 Update

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® Better Outcomes and Better Value for Specialty Care Provides a quality-based, financially savvy implies for adaptable advantage outline National managers utilizing and advancing Blue Distinction for part training and highlighting offices offering better general results Others creating differential advantage outlines to energize or require utilization of Blue Distinction Centers

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® Better Outcomes and Better Value for Specialty Care Provides a quality-based, practical means for adaptable advantage plan Example of Benefit Design driven by Blue Distinction 52,000 individuals 2,500 branch workplaces crosswise over 24 states Tailored advantage configuration to make up for bariatric surgery just at Blue Distinction Centers, included supporting travel advantage Effectively guided individuals to higher quality care … [BCBS] set up bariatric focuses of fabulousness. That is helped us from the viewpoint of ensuring it's a top notch administration that is provided." – Bruce Wilson Senior Vice President, Compensation and Benefits

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® Better Outcomes and Better Value for Specialty Care ABC Manufacturing High frequency of cardiovascular care require in SIC arrangement, especially among more seasoned, male laborers in Upper Midwest BCBS total cases information triggers focused on instruction materials and assets to at-hazard worksites Biometric screenings Health fairs/workshops Distribution of Blue Distinction Provider Directory Members who require claim to fame mind and select Blue Distinction offices encounter better general results, with less intricacies and lower general expenses

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 ®  Blue Assets and Programs: Maximizing the Value of Your Customer's Healthcare Dollar Your Customer's Critical Healthcare Needs The Strength that The Blues ® Deliver Target human services dollars Better general wellbeing results and quantifiably bring down costs Increasing part wellbeing engagement at the worksite

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Questions??

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