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May 2009 Dear Business Partner: We begin this month's BlueLinks eNews by reporting our first quarter results for 2009, and we would like to thank you once again for your continued hard work and commitment in today's challenging economic environment. This month's eNews features an important article about Quality = Affordability, a simple equation that represents our vision of how, working together, we can solve the challenges facing the American health care system. You will learn how the changes we are making, both within our organization and as an insurer, are inexorably linked to this important mission. We then update you on the rollout of our online billing tool, eBill, and proudly announce the launch of our enhanced online comprehensive wellness platform, MyBlueHealthSM. As always, if you have any questions or comments, please don't hesitate to share them with your account executive. Sincerely, Larry Croes |
First Quarter 2009 Results Announcement
Today we reported our first quarter 2009 financial results. We would like to thank you for your ongoing dedication and support in today's competitive environment. We appreciate the opportunity to continue to serve you and your clients.
For details about our first quarter results, please read our recent press release. If you have any questions, please contact your account executive.
At Blue Cross Blue Shield of Massachusetts, we believe the most promising way to slow rising health care costs is to improve the quality, safety, and effectiveness of the health care our members receive. It's an approach we've summarized in a simple equation: Quality = Affordability. We believe that better care will lead to more affordable care, and we are working on a number of initiatives designed to reach that solution. We view this work as essential to fulfilling the promise we've made to our members: to always put their health first.
Our Quality = Affordability Strategy
Our efforts to improve the quality and affordability of heath care focus on four key areas: payment reform, improving the quality and effectiveness of care, empowering our members, and investing in the community.
Payment Reform
We believe improving the quality of care must begin with changes in the way insurers reimburse doctors and hospitals. The current fee-for-service reimbursement system is not working. It creates incentives for doctors and hospitals to use more services than appropriate, but does not offer providers the right incentives to strive for the best clinical outcomes. The Alternative Quality Contract, Blue Cross Blue Shield of Massachusetts' new contract model, offers doctors and hospitals the opportunity to earn significantly higher payments based on health care quality, while at the same time moderating cost increases for employers and members. In 2009, several physician groups and hospitals have partnered with us under this innovative new contract, which is designed to improve the quality of care our members receive and cut the current medical cost trend in half.
Improving the Quality and Effectiveness of Care
We are working with doctors and hospitals to address the overuse, underuse, and misuse of health care services that don't improve the quality of a patient's care, but do add significant unnecessary cost to the system.
Overuse
We are expanding the reach and impact of our evidence-based utilization management (UM) programs to address the overuse of procedures, such as knee arthroscopies, back surgeries, and joint replacements. To encourage the use of less expensive generics over brand-name drugs, we are enhancing our pharmacy formulary and step-therapy programs. We are also sharing information about practice pattern variation to help providers identify areas for improvement. Additionally, we have created a number of network, member education, and 24-hour clinical access programs to reduce the volume of non-urgent emergency room visits.
Underuse
Using health care services infrequently can jeopardize members' health. To mitigate the risk of underuse, Blue Cross Blue Shield of Massachusetts is enhancing our care management programs to help members better manage chronic illnesses, improve their health, and navigate the health care system. We are removing barriers to care, thereby increasing the likelihood that diseases are diagnosed early when treatment is most effective and least costly. And we have a range of programs that promote behaviors aimed at reducing the onset of diseases that are exacerbated by unhealthy lifestyle habits.
Misuse
To moderate the misuse of health care services, we are communicating with members and providers to increase the use of generic medications when there is no proven added clinical benefit to their more expensive brand-name counterparts. We are also developing programs to drive members to get clinically equivalent services in the most appropriate location. And we are providing members with quick access to convenient, high-quality urgent care services as an alternative to expensive emergency room visits.
Empowering Our Members
The single most important thing members can do to ensure that they receive safe and effective care is to take an active role in their health and wellbeing. We provide our members with innovative tools, products, and resources that help them find high-quality, safe, and cost-effective health care. By using this information to guide decision-making, members can stay healthier and recover more quickly when they become sick. Our tiered network plans are designed with the importance of member engagement in mind, offering significant financial incentives when members seek care from a doctor or hospital that delivers high-quality care at the lowest cost.
Investing in the Community
We continue to invest in community-based initiatives focused on improving the quality, safety, and effectiveness of health care services. These investments have ranged from financial incentives for hospitals and physicians to contributions to the Massachusetts eHealth Collaborative and the eRx Collaborative and funding of the Partnership for Healthcare Excellence, among others.
A Changing Blue Cross Blue Shield of Massachusetts
As we strive to realize our goal of a high-quality, affordable health care system, Blue Cross Blue Shield of Massachusetts is doing its part to find new efficiencies in the way we run our business. This includes restructuring departments, implementing process improvements, and adopting and deploying advanced technology and information systems.
Quality = Affordability Now
Quality = Affordability offers the greatest hope of delivering on the promise of safe, effective, affordable health care. Together, with the help of employers, brokers, members, and government, we can transform the way health care is delivered and paid for.
Blue Cross Blue Shield of Massachusetts has started switching insured accounts to eBill, our secure online billing tool. eBill can help your clients drastically reduce the amount of paperwork associated with health, dental, and other insurance invoices, and allows them to:
- Make online payments at no charge
- Set up recurring debits from their bank
- Sort and export invoices as Excel and/or PDF files
- Access reporting tools as well as an 18-month archive of invoices and payments
- View and manage multiple invoices
- Manage/limit user permissions and access and offer simultaneous multi-user access
- Stop paper invoices and "go green"
To learn more about eBill and to see a demo, visit BlueLinks for Brokers or contact your account executive.
Enhanced Login to Access Employer Tools
Blue Cross Blue Shield of Massachusetts is making it easier for your clients to manage their account from a single location at BlueLinks for Employers. Employers will have quick access to Enrollment Management, Online Billing, and Forms and Documents from easy-to-find links located on the left side of the employer home page. Watch for additional enhancements to BlueLinks for Employers this summer to help your clients better navigate important news, updates and other communications.
Note: The Enrollment Management link on BlueLinks for Brokers, located under "Quick Links" will now land on a new login page for Enrollment Management. This provides easy access to Enrollment Management.
MyBlueHealth: Healthy Change Is Here
Blue Cross Blue Shield of Massachusetts is committed to providing prevention and wellness programming for employers that will deliver consistent, targeted solutions for their entire employee population—regardless of their health plan*.
With that in mind, we are very pleased to announce the launch of an enhanced version of
This comprehensive prevention and wellness solution will lay the foundation for deploying strategies that increase employee engagement and use of wellness tools, which will help drive long-term behavior change.
MyBlueHealth enhancements include an expanded suite of online programs, including a new health assessment, interactive exercise demonstrations to ensure proper technique and form, and health coaching. MyBlueHealth also features customized fitness, nutrition, and health improvement plans, telephonic coaching, social networking communities, tracking tools, reporting capabilities, onsite wellness activities, offline solutions, and wellness program promotion and engagement strategies.
Our goal is to continue to provide easy-to-use prevention and wellness programming that helps employees manage their health and quality of life, regardless of where they fall on the health continuum.
For more about the new MyBlueHealth, please visit BlueLinks for Brokers for additional information and to access a new fact sheet to assist your employer groups with 51 or more subscribers.
* Services are available to non-Blue Cross Blue Shield of Massachusetts plan members for an additional fee.
If the above links are not functioning in your email, copy and paste the URLs listed below into a browser window:
2009 1st Quarter Financial Results Press Release
http://www.bluecrossma.com/bluelinks-for-brokers/pdf/enews/05-2009/press-release.pdf
BlueLinks for Brokers Online Billing
http://www.bluecrossma.com/bluelinks-for-brokers/manage-your-business/online-billing.html
BlueLinks for Employers
http://www.bluecrossma.com/employer
MyBlueHealthMA
http://www.mybluehealthma.com
Broker Fact Sheet
http://www.bluecrossma.com/bluelinks-for-brokers/pdf/enews/05-2009/fact-sheet.pdf
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2009 Blue Cross and Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross Blue Shield Association. |