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Quality Care Rewards | February 2017

This information applies to all lines of business unless stated otherwise.

Help Your Patients Take Control of Their Heart Health

Encouraging your patients to manage their blood pressure by checking it at home and keeping a journal may lead to better heart health. At-home monitoring can help your patients maintain their blood pressure within the following ranges:

  • 18-59 Years of Age: <140/90
  • 60-85 Years of Age: Diabetic: <140/90
  • 60-85 Years of Age: non-Diabetic: <150/90

Decrease the Risk of a Second Heart Attack
A previous heart attack increases the risk of having a second. Beta-blockers are shown to lower the risk of having a second heart attack, and to help prevent sudden cardiac death. For patients that have recently experienced a heart attack, it is important to encourage them to take the prescribed beta-blocker medication for at least six months after their heart attack.

SilverSneakers ® Benefit for BlueAdvantage and BlueChoice Members

BlueCross provides benefits to your BlueAdvantage and BlueChoice patients designed to keep them heart healthy. Talk to them about the importance of physical activity, and let them know about SilverSneakers, a free gym membership included with their BlueCross Medicare Advantage Health Plan. SilverSneakers has hundreds of participating locations across Tennessee.

Reminding your patients about the importance of physical activity, along with taking steps to make sure their blood pressure is under control, and keeping them adherent with their prescriptions for conditions like high cholesterol or hypertension, may help boost your quality scores and earn fee schedule bonuses from BlueCross.

Pharmacotherapy Management of COPD

Early diagnosis and aggressive treatment of Chronic Obstructive Pulmonary Disease (COPD) may improve a patient’s quality of life and lifespan.

Adequate control of COPD relies on the proper use of both short-acting and long-acting medications. The National Committee for Quality Assurance recommends that after a COPD exacerbation a patient be prescribed and dispensed a systemic corticosteroid within 14 days of discharge, as well as a bronchodilator within 30 days of discharge.

Tips to help increase COPD medication adherence:

  • Incorporate prescriptions and medication instructions in discharge planning.
  • Offer to “call in” prescriptions to your patient’s home pharmacy to make picking up their prescriptions more convenient and increase the likelihood for medication adherence.
  • If the hospital has an in-house pharmacy, encourage your patients to fill prescriptions before leaving.
  • Explore reasons for non-compliance and initiate Case Management if needed.

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