GuidedHealth — Making a good thing even better

We created GuidedHealth® in 2012 to help members and doctors make better decisions about medicine. Its programs analyze medical and pharmacy data to improve care — resulting in better outcomes and lower total cost of care. We recently added programs and enhanced others to improve care and satisfaction for members, doctors and our Blue Cross and Blue Shield Plan clients.

Improved adherence, alerts and action

Here’s what’s new about GuidedHealth:

  • Enhanced adherence programs. We have more than 30 programs to support quality care measurements. We recently added schizophrenia and childhood asthma. Our programs all support HEDIS quality care measures. HEDIS stands for Healthcare Effectiveness Data and Information Set. It’s a tool used by more than 90 percent of America's health plans to measure performance on important dimensions of care and service. Because many plans collect HEDIS data, and because the measures are so specifically defined, HEDIS makes it possible to compare the performance of health plans on an "apples-to-apples" basis.
  • New opioid alert program. This program helps spot potential overuse or abuse of opioids and engages doctors to help prevent negative health events. In a 2014 National Survey on Drug Use and Health (NSDUH), 50.5 percent of people who misused prescription painkillers got them from a friend or relative for free, and 22.1 percent accessed them from a doctor. 
  • Better feedback from doctors. We’ve automated feedback through an online survey. This allows us to collect feedback more quickly and efficiently so we can continue to improve GuidedHealth based on what doctors tell us.
  • Improved feedback and reporting. We listened to our clients and revised our reports to make them easier to understand and more reflective of savings.
  • Point-of-care messaging pilots. Using electronic health records to deliver clinical messages to doctors during the member’s office visit helps doctors make better decisions at the point of care. We’re using pilot results to develop scalable programs and make messaging more effective. 

Making a good thing even better

Prime’s investments in GuidedHealth will result in a more comprehensive suite of programs, as well as improved efficiency and doctor satisfaction. We also expect to deliver improved member health outcomes and annual total cost-of care savings. For information on Prime’s enhanced GuidedHealth programs, contact your Prime representative.

GuidedHealth is a registered trademark of Prime Therapeutics LLC.

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