Recently, the Blue Cross Blue Shield shifted away from fee-for-service medicine to total care medicine, which provides value-based healthcare to patients. This form of healthcare not only results in a more positive outcome for patients, but, also enhances the overall health of patients. As a result of this particular shift in patient care, the company claims that they now spend well over $145 billion each year on the total care medicine. The company states that the number of companies that they have which will shift to total care is only expected to grow because the fee-for-services pay approach only results in unnecessary medical tests and treatments.
The total care medicine program that is now offered by Blue Cross Blue Shield emphasizes total patient wellness. This includes preventive measures, wellness steps, and disease management. As a whole, this type of care is better coordinated for patients and does not result in the duplication of tests and/or medical treatments. Duplication of these tests and treatments only result in waste. Due to the immense success for the companies and patients that have been provided with total care services, the Association is anticipating the release of more medical programs across the nation that deliver total value care. This is a new network plan that is being identified as the “Blue Distinction Total Care Program”.
The Blue Distinction Total Care Program will have the ability to reach 13 million members of the Blue Cross Association. This is made possible through a total of 118,000 professionals in the healthcare field. It is believed that, with such a large medical-based network, patients and employers that offer healthcare insurance will have access to the care that they need, when they need it, at the most affordable price possible. Not only does this total care program aid patients and employers, it also helps doctors, clinics, hospitals, and private-care –physicians to work together in order to optimize the quality of healthcare being provided to patients, while reducing costs. The total care value programs that are currently available are being referred to as “Pay for Performance”. In some instances, they may be called “Episode-Based Payment Programs”.
If you are providing healthcare services to patients – be it physical therapy or rehabilitation therapy – it is important to get onboard with the value-driven healthcare programs that are currently available. Initially, you may see an increase in costs, but, over time, you will see an increase in profits. Patients only want the medical tests and services that are absolutely necessary to their health and well-being. They want to be treated as individuals, not as a group. The fee-for-service models only benefit the providers that perform them by putting more money in their pocket. They do not benefit the patients. Despite initial costs, Blue Cross Blue Shield recognizes the unique advantages of providing total care value-driven services. For more information on this topic, you may view other reports that we have included on our blog. Simply click HERE for immediate access to those reports.