Consumers typically look for value cues when making a purchase. Yet health care is not an industry that typically supports consumer thinking when it comes to cost and quality concerns. Or even encourages questions and comparisons – tools that consumers instinctively use for other types of significant spending.

BlueCross BlueShield of Tennessee is changing that mindset with a central focus on health care transparency, creating access to information that supports consumer health choices based on quality of care, proven results, affordability and value.

Blue Distinction – leading initiatives for transparency
In 2006, BlueCross BlueShield of Tennessee actively launched its participation in the Blue Distinction program, a nationwide collaboration of Blue Plans working to create an unprecedented level of transparency within the health care system. The Blue Distinction program has two goals: to engage consumers to make more informed health care decisions, and to collaborate with providers to improve quality care outcomes and affordability.

Working with leading hospitals, physicians and medical specialty societies, Blue Distinction transforms raw hospital and physician data into accessible, understandable and personalized information. Available to Tennessee plan members, and the more than 95 million other Blue Plan members nationwide, Blue Distinction provides comprehensive health care quality and affordability information based on objective, consistent and common standards.

Blue Distinction Centers
Focusing on quality care with consistent outcomes, Blue Distinction Centers for bariatric surgery and cardiac care were established in Tennessee and across the nation in 2006, building on the Blue Distinction Centers for Transplants first established in 1991. The centers demonstrate our commitment to work with doctors and hospitals in communities across the state and country, to identify leading institutions that meet clinically validated standards for quality care and results.

As an example, a Blue Distinction Center for bariatric surgery must provide a full range of bariatric surgical care services, including inpatient care, post-operative care, follow-up and patient education. A chosen facility must also meet stringent quality criteria, as established by expert physician panels, surgeons, behaviorists and nutritionists. The Blue Distinction program helps plan members locate quality care for bariatric surgery, and make more informed surgical choices based on patient safety and care measures.

Hospital measurement and improvement program
In addition, employer groups and brokers now have access to the Blue Distinction Hospital Measurement and Improvement Program tool, a new transparency tool located within BlueAccess on bcbst.com. The new quality performance tool, produced by the BlueCross BlueShield Association, provides nationwide reports and Tennessee-specific data that help uncover and compare quality and safety measures for hospitals in Blue networks across the country.

The easy-to-use reports focus on care for heart attacks, heart failure, pneumonia and infection prevention, and use evidence-based clinical measures from the Centers for Medicare and Medicaid Services. In addition, patient safety indicators are included from the Agency for Healthcare Research and Quality.

Blue Health Intelligence
Blue Health Intelligence brings together the depersonalized claims experience of 79 million BlueCross and BlueShield members nationwide, creating the nation’s broadest, deepest pool of claims information. More than twice the size of the next largest database, Blue Health Intelligence is the industry’s most accurate and reliable resource for planning and decision-making.

Blue Health Intelligence is intended to provide employers and brokers unmatched detail about health care trends and best practices. In addition, it creates new opportunities for physicians, researchers and health policy makers – working together with BlueCross BlueShield of Tennessee – to improve the quality and consistency of care.