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Technology and partnerships can improve primary care experience for Tennesseans

Primary care providers, or PCPs, are the core of quality health care. Building a relationship with a PCP is one of the best ways a person can pursue better health.

PCPs get to know their patients, including family history and future risks. They treat common, non-emergency conditions, help manage chronic health issues and connect patients to specialty care when it’s needed.

Unfortunately, too many Tennesseans lack sufficient access to primary care  — or it’s not convenient enough to fit easily into their daily lives.

A 2016 study by the Tennessee Department of Health examined the 30 counties with the worst ratios of residents to PCPs. Many of those counties, as you might expect, are in rural parts of Tennessee. But urban areas aren’t immune to this – Davidson and Shelby counties made the list, too.

Virtual primary care, or telehealth, is one way we can help close the gap. And more Tennesseans are embracing that solution, especially the members we serve through Affordable Care Act Marketplace plans. So in 2020, we’ll offer most of those members lower co-pays on telehealth visits – including a free initial consultation.

In addition to expanding access through services like telehealth, we’re doing more than ever to help PCPs deliver cost-effective care that meets the highest health and wellness standards.

One example is our new Medical Home Partnership (MHP) program. For years, we’ve collaborated with PCPs through the “patient-centered medical home” model. Those practices offered extra support to coordinate care, particularly for people with chronic health conditions like diabetes or heart disease.

We connect participating PCPs with clinical data that helps them make sure patients get the right screenings and preventive care. We also put BlueCross-employed nurses in the offices of many of these practices across the state, where they work alongside PCPs to better meet patients’ needs. These partnerships have been successful at lowering emergency visits and inpatient stays, as well as helping Tennessee employers save money.

More importantly, we’ve seen how our embedded care coordinators – working in practices alongside the physicians at Saint Thomas here in Nashville, and others across the state — have helped improve the quality of life for the members we serve together.

BlueCross Kelly Hutchison
As a BlueCross care coordinator, Kelly Hutchison provides a face-to-face support system for members in need. Here’s the story of how she helped Nashville resident Charles Henderson.

Our Patient-Centered Medical Home program was originally focused on members with chronic health conditions, but our Medical Home Partnership will expand support to more of our members — no matter what their health and wellness goals are.

We also know that convenience matters, especially for preventive or maintenance care that might not feel urgent to someone.  That’s why, through another effort, we’re investing in primary care with physician practices across the state to make it easier for our members to get care when they need it.

Here are two recent examples of how our innovation grants will help improve the primary care experience:

  • Galen Medical Group in Chattanooga will launch an improved online portal to streamline the process for setting appointments and let patients use electronic messaging with their PCPs.
  • State of Franklin Health Care Associates in Johnson City will use technology to help patients better understand the costs of their services. They’re also adding online scheduling and telehealth services.

We’ll keep working with partners across the state to evolve the primary care experience – making it more accessible and more convenient.

Together, we can bring better health to the people we serve in Tennessee.

About Henry Smith, SVP, Ops & Chief Marketing Officer

A photo of the authorHenry oversees sales and account management, product development, group and member customer service, membership administration, claims administration, and commercial financial management.

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