June 7, 2013

First Practices Join Quality Blue Primary Care

Three primary care practices—West Monroe Family Clinic, West Calcasieu Virtual Medical Home and Baton Rouge General Physicians—have signed up for Quality Blue Primary Care (QBPC), Blue Cross and Blue Shield of Louisiana’s innovative population health and quality improvement program. QBPC is designed to get better outcomes for patients with chronic diseases, support doctors and transform healthcare delivery.

Blue Cross is implementing QBPC in primary care physicians’ offices and clinics, and will roll it out statewide over two to three years. In the early months of QBPC, Blue Cross is signing up network primary care practices that treat the highest number of members with chronic diseases such as diabetes.

“We were the first provider group in the state to sign on with QBPC, and we believe this will create a truly collaborative care environment. Our staff will work closely with Blue Cross so that together, we can help our patients become healthier and remain well,” said Steven McMahan, M.D., physician with West Monroe Family Clinic in West Monroe, La.

“Partnering with Blue Cross and Blue Shield to offer this program in our community demonstrates the benefits of working together to improve health outcomes, while reducing cost,” said Bill Hankins, chief executive officer at West Calcasieu Cameron Hospital and president of the West Calcasieu Virtual Medical Home in Sulphur, La.

Hankins said that while the West Calcasieu Virtual Medical Home is centered around the QBPC, it is unique in that seven primary care sites in Calcasieu Parish have joined together and will be part of the program. These sites are The Cypress Clinic, Schlamp Family Medical, Calcasieu Family Physicians, Gamborg and Cavanaugh Family Medicine, The Family Care Center of SWLA, The Family Practice Center of Sulphur and Maplewood Family Medicine.

“Not only does this improve care coordination efforts, but it also allows for the enhancement of primary care services for current and future patients. We are excited to be one of the first QBPC providers and are enthusiastic about working with Blue Cross and Blue Shield to implement this new population health-focused program,” Hankins said.

“This program is an important step toward enhancing patient care, improving the overall quality of healthcare in our state and also reducing costs,” said Brad Gaspard, M.D., family medicine physician with Baton Rouge General Physicians in Baton Rouge. “We are committed to enhancing the health and well-being of the communities we serve, and we are excited to be among the first providers in Louisiana to partner with Blue Cross and Blue Shield of Louisiana in leading this innovative program.”

David Carmouche, M.D., chief medical officer for Blue Cross and Blue Shield of Louisiana, said that Quality Blue Primary Care is the next generation of population health management. “This model will significantly improve patient outcomes and support providers. We are making a substantial investment by paying for software and helping the participating practices through the transformation,” Carmouche said. “This will give our providers the data and support they need to improve both overall healthcare quality and the lives of their individual patients with chronic diseases.”

Two years ago, Blue Cross began using a model for primary care called the patient-centered medical home, or PCMH. It focused on improving patients’ health and lowering costs. Both QBPC and PCMH offer organized, team-based, proactive care that works to prevent disease and protect or restore health.

QBPC builds on the basic features of PCMH to offer an enhanced model for population health, in which providers can focus on improving care quality for their total patient population, not just those who are actively seeking treatment. Blue Cross will offer QBPC practices the technical and clinical support and guidance they need to manage their patients’ care in the least disruptive way. The QBPC payment structure rewards providers for better patient outcomes, with a care management fee paid on top of their usual fee-for-service setup.

“Baton Rouge General Physicians experienced the benefits of a coordinated team approach to patient care through our work in building a patient-centered medical home. We are pleased to see QBPC is taking the lessons we’ve learned and creating an even more effective model of support for our primary care practices,” said Ed Jeffries, M.D., chief medical officer with Baton Rouge General Physicians. In December 2011, Jeffries’ group was the first to sign a formal agreement with Blue Cross to build a PCMH.

Blue Cross contracted with two strategic collaborators, MDdatacor and Integrated Medical Practices, to support QBPC. MDdatacor supplies healthcare IT solutions that empower payers and providers to deliver the highest quality healthcare possible. Blue Cross will use the company’s proprietary MDinsight® technology to help practices identify, manage and improve the quality of care for their patients. MDdatacor currently supports 10 Blue Cross and Blue Shield plans throughout the country with its MDinsight software solution.

Integrated Medical Processes, LLC (IMP), a clinical integration consultancy focused on population management and value-based care models, is establishing the framework and implementation strategy that will allow this group of healthcare quality leaders to begin the process of truly transforming our healthcare system.

“We have the finest physicians in the world, but our system for providing healthcare is broken,” Carmouche said. “We’re working to change that with Quality Blue Primary Care, which combines MDdatacor’s cutting-edge technology, IMP’s superior knowledge of healthcare delivery and Blue Cross’ deep understanding of the healthcare needs in our state. We’ve got nearly 80 years of commitment to the communities of Louisiana, and I believe we’ll be able to provide an innovative solution that fundamentally changes the way providers approach chronic care management.”

Carmouche added, “Our changing healthcare landscape will present challenges, and this care model puts us ahead of the curve. It will make this transition easier. With Quality Blue Primary Care, we are making the right thing to do the easy thing to do.”

For more on Quality Blue Primary Care, visit www.bcbsla.com/qbpc. Carmouche is on Twitter at @DrCarmouche and hosts a LinkedIn group called the Louisiana Quality Care Network where healthcare professionals share information and best practices.

About Blue Cross and Blue Shield of Louisiana
Founded in New Orleans in 1934, Blue Cross and Blue Shield of Louisiana is the oldest and largest Louisiana-based health insurance company. Blue Cross is a private, fully taxed mutual company, owned by policyholders—not shareholders—and governed by a local Board of Directors. It is an independent licensee of the Blue Cross and Blue Shield Association.

The company and its subsidiaries provide group and individual health insurance plans, life and disability insurance, group voluntary products and administrative services to more than one out of every four Louisiana residents. With headquarters in Baton Rouge and eight district offices, Blue Cross and Blue Shield of Louisiana employs more than 1,900 Louisianians who are committed to improving the lives of its customers by providing them with health guidance and affordable access to quality care.

Learn more on the company's website at www.bcbsla.com or on Facebook at www.facebook.com/bluecrossla. Follow Blue Cross on Twitter at www.twitter.com/BCBSLA and CEO Mike Reitz at www.twitter.com/MikeReitzCEO