Value-Based Quality Improvement Initiative with a Major Healthcare Insurer in the Southeast 2013-2016

Improved Cardiovascular Clinical Metrics in a collaborative project called QBPC sponsored by BCBS of Louisiana, which targeted their primary care networked physicians. The project succeeded in showing that risk factor management can be improved by engaging primary care providers with a performance improvement process designed around best practices.

An innovative, quality-driven transformation model developed by COSEHQ and The Kinetix Group, in partnership with Blue Cross Blue Shield of Louisiana (BCBSLA), moved Louisiana-based primary care clinicians towards a value-based care delivery and reimbursement model.  The model’s key strategies included embedded evidence-based guidelines, professional education, data transparency, frequent physician performance reviews and enhanced patient engagement support, such as care management offered by BCBSLA.  The program focused on 4 chronic conditions: diabetes, hypertension, chronic kidney disease and vascular disease. These prevalent and costly chronic conditions were targeted because they represent significant opportunities to improve patient outcomes and reduce costs. Results in the first year of the program were impressive.

Primary Care Network Redesign at a Major Health Plan