Facts

Blue Cross is transforming healthcare with our Quality Blue programs. Instead of paying doctors based on how many patient visits they can cram into a day, we are paying them based on how well they help their patients get healthy.

The facts show our approach of supporting doctors in getting better health results for you, which saves money, is working. How Does Better Health Lead to Lower Costs? Simply put, when people get healthier, medical costs go down, and everyone gets more value for their healthcare dollars.

While cost and quality are a national problem, these are a particularly big problem in Louisiana — half of our adult population has at least one chronic health condition, accounting for up to 70% of all medical costs.

On the cost front, Louisiana fares poorly compared to other states. In 2013, the Institute of Medicine reviewed variations in healthcare spending among 306 hospital referral regions. Six of the 10 highest-spending areas in the country are located in Louisiana, representing all of the state’s major metro areas.

Without taking big steps to address chronic disease and help people get healthier, costs will just keep going up. That’s why it’s important for everyone – doctors, patients, employers and insurance companies – to work together to improve health, keep costs in line and drive more value.

In 2013, Blue Cross and Blue Shield of Louisiana launched Quality Blue Primary Care. We are the only health insurance company in Louisiana to offer this type of program.

Quality Blue is based on the approach that when doctors work with patients to improve their health quality outcomes, especially for patients who have chronic conditions, healthcare expenses go down.

In the two years of Quality Blue, the doctors participating have gotten better health results for their patients with long-term health problems like diabetes, heart disease, high blood pressure and kidney disease.

Helping our customers get healthier not only gives them a higher quality of life, it saves them money.

Consider these data:

• When a pre-diabetic person becomes diabetic, the average annual cost of treatment is $6,667.
• When a hypertensive person has uncontrolled blood pressure and has a stroke it costs, on average, $15,000 to treat that person in the first 90 days after the stroke.
• When a heart disease patient with uncontrolled cholesterol levels has a heart issue, the average cost of treating that person for the first five days is $21,500.
• The average annual cost for treating a person with chronic kidney disease is $23,500. If the condition worsens and this person requires dialysis, the cost jumps to $100,000 a year.

Early Results Show Quality Blue Saves Money.

Quality Blue cost data from the first full year of the program (2013-2014) show that:

• Blue Cross customers seeing Quality Blue doctors had lower monthly healthcare costs than other customers.
• A key reason these customers’ costs were lower is because they needed fewer hospital stays. Care in a hospital costs much more than care in a doctor’s office or clinic. The more people can get care outside of a hospital, the less it costs.
• Customers seeing Quality Blue doctors are getting more care in a doctor’s office. These customers had more checkups with their primary care doctors and higher rates of getting needed screenings and tests (like blood sugar readings or blood pressure checks) than other customers.

Why Are Quality Blue Costs Lower?
In Quality Blue, we work with primary care doctors in their networks to support them in doing what they do best – treating their patients. The doctors focus on doing outreach to their patients, getting them to have necessary screenings or shots, and connecting them with a Blue Cross nurse for health coaching to stay on top of their needs.

With all these factors, the doctors are getting better health results for their patients, and doing more preventive care to keep any problems from getting worse and needing more serious treatment – and that costs less.