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We know our members want convenient, cost-effective primary care that meets high clinical quality standards. And we want to support the people who serve our members – especially primary care providers who are committed to patient-centered principles and being paid based on how well they support members in achieving health outcomes.

In 2019, BlueCross issued the first of several innovation grants to fund our primary care partners’ investments in a variety of resources  aimed at improving the overall patient experience.

Collaborating to cultivate patient-centric practices

“Patients who have convenient choices for treatment are more likely to follow their health care provider’s guidance and get the services they need in a timely fashion,” says Nancy Muldowney, clinical manager for the BlueCross patient-centered medical home program. “That leads to better health outcomes.”

Our members tell us they want options like extended hours, next-day appointments, electronic appointment scheduling, telehealth and online check-in. These offerings can reduce wait times for those who visit their primary care providers, which boosts overall member satisfaction.

So far, BlueCross has awarded member experience improvement grants to two multi-specialty practices, Chattanooga-based Galen Medical Group and Johnson City-based State of Franklin Health Care Associates (SoFHA).

The groups, part of our Quality Care Partnership Initiative (QCPI), are using their BlueCross funding to invest in a variety of enhancements.

• Galen aims to improve communication between providers and patients with a new online portal that allows for secure messaging and streamlined appointment setting. A new web interface and hardware (iPads and payment kiosk) also support automated payment processes including online statements, credit card processing and Apple Pay.
• SoFHA will soon launch a platform that will enable patients to self-schedule appointments online. The practice is also investing in a pregnancy app for expecting mothers, and evaluating options for technology that will provide patients with greater cost transparency around services and payments.

Building on success

It’s no surprise that Galen Medical Group and SoFHA are the first two practices to participate in BlueCross innovation grants. These practices’ commitments to advancing quality patient care have already helped thousands of BlueCross members overcome personal challenges and improve their health.

“As patients are becoming more aware of their primary care choices, it’s vital we increase our responsiveness as providers and engage in innovative ways so that health care is more accessible and convenient,” says Rich Panek, CEO of SoFHA, the highest-ranked practice in our QCPI program.

“These efforts, part of our overall commitment to quality care and enhanced patient satisfaction, increase the likelihood that someone will seek care at the appropriate time and follow the instructions offered by their provider.”

Care that makes a difference

Rick Moulton, M.D., medical director for SoFHA, shared an example of how its current quality care processes helped a patient with chronic health conditions (including diabetes, hypertension, high cholesterol and obesity).

“She would frequently miss her appointments,” Dr. Moulton says, noting that due to various personal challenges, “she wasn’t following through with all of her necessary screenings.”

SoFHA’s expanded care team joined the physician in helping address the patient’s barriers to treatment. A case manager reached out to her to find the most convenient times for her upcoming visits, and the practice’s on-staff pharmacist scheduled time at her next appointment to go through the different medicines she was taking and talk through any issues, a process known as medication reconciliation.

While the process took time, the results were positive.

“Over the last couple of years, she’s gotten better at taking her medications as prescribed,” Dr. Moulton says. “And at this point, all of her [medical issues] are controlled and she’s completed her screenings, including her diabetic eye exam, mammograms, colon screening and vaccination.”

This type of care effectively reduced the patient’s risk of developing complications from chronic conditions, ultimately improving her quality of life – a goal for all those we serve.

Measuring success, looking toward the future

Both SoFHA and Galen Medical Group are committed to providing BlueCross with information about the results of their respective innovation investments. They’ll share data such as:

• how many patients scheduled appointments online
• how often patients are using resources like portals and apps
• how satisfied patients are overall thanks to these new offerings.

“It’s really all about how we combine technology and an emphasis on personal medicine to give patients the best of both worlds,” said Charles Lathram, administrator of Galen Medical Group. “These resources help us increase the opportunity for care coordination – it gives our physicians increased access to and ease of use of information, which improves the overall experience for our patients.”

Clay Phillips, vice president of provider network strategy and value-based contracting for BlueCross, agrees.

“The data we receive from these pilot practices will help us understand which innovations mean the most to the members we serve,” he says. “This will enable us to improve our members’ experience when they visit primary care providers in our networks.”

As BlueCross gathers data from these first grant recipients, other primary care practices in the company’s value-based programs can seek innovation grants tailored to their needs for experience improvement.

“By investing in our provider partners this way, we hope to help elevate the primary care experience throughout the state, which will ultimately increase peace of mind and improve health  for the members we serve,” Clay says.

Dr. Moulton is grateful for the relationship BlueCross has developed with SoFHA, and recommends the approach to others.

“BlueCross comes to the table as a true partner, as far as the discussions and understanding of how to seek better health care,” he says. “The exchange feels like an equal partnership, and that is something groups should pursue.”

“We improve health care when we work together.”