|March 21, 2007|
BlueCross Tackles Threat of Deep-Vein Thrombosis
CHATTANOOGA, Tenn. — Each year approximately two million Americans are affected by deep-vein thrombosis (DVT), a medical condition that occurs when a blood clot forms in one of the large veins. The condition may result in a pulmonary embolism (PE) or even death if not properly diagnosed and effectively treated. To combat this serious threat, BlueCross BlueShield of Tennessee has stepped up as the first managed care organization in the country to launch a quality DVT awareness and prevention program.
According to an American Public Health Association survey, 74 percent of individuals have little to no awareness of DVT. That lack of knowledge leads to as many as 600,000 annual hospitalizations from DVT and as many as 200,000 deaths from those developing a PE—more deaths than the number caused by breast cancer and AIDS combined.
“A little information goes a long way,” said Dr. Ken Patric, chief medical officer for BlueCross. “We realized that our health plan had the data and resources to proactively reach out to our members, impact their quality of care and improve their health outcomes.”
From April to June 2006, BlueCross conducted a pilot DVT Awareness Program. The pilot consisted of BlueCross commercial transition of care nurses identifying in-patient admissions for scheduled procedures carrying the greatest risk for DVT complications. Those procedures included total hip, total knee or abdominal surgeries. The study population was commercially-insured members 40 to 60 years of age.
Following identification, the medical team contacted admitting physicians to explain the program and obtain consent to discuss the program objectives and review the risk assessment tool with the member/patient.
During the course of the pilot, 440 members participated. These members were assessed for DVT risk factors and their status was followed both during their hospital stay and after discharge. An initial data analysis reflected a significant reduction in incidents of DVT and a re-admission rate of just 10 percent.
Besides the health implications, DVTs also carry a heavy financial cost. According to researchers, the estimated direct cost of treating a DVT/PE in the United States exceeds $12 billion annually. For each DVT event, reimbursed costs are approximately $7,712 and $12,000 for a combined DVT/PE event. During the BlueCross pilot, an estimated $1.2 million in potential costs for members and the health plan were avoided.
“The BlueCross DVT program is in line with the National Coalition to Prevent DVT and its efforts to reduce the immediate and long-term dangers of DVT and PE,” said Nancy Skinner, a member of the coalition. “We’re pleased that BlueCross BlueShield of Tennessee is setting a standard for MCOs to develop strategies that address this very preventable condition.”
With the success of the pilot, BlueCross has expanded its DVT Awareness Program to include 16 to 60 year olds within all lines of company business. To date, more than 1,500 members have benefited from the program.
BlueCross BlueShield of Tennessee's mission is to provide its customers and communities with peace of mind through affordable solutions for health and healing, life and living. Founded in 1945, the Chattanooga-based company is focused on reinventing the health plan for its 3 million members in Tennessee and across the country. Through its integrated health management approach, BlueCross provides patient-centric products and services that drive health improvement and positively impact health care quality and value. BlueCross BlueShield of Tennessee Inc. is an independent licensee of the BlueCross BlueShield Association. For more information, visit the company's website at www.bcbst.com.
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