Our connections pave the way for innovation

The health care industry is changing more quickly than ever. To foster continued success in controlling costs while helping people get the medicine they need, we are consciously evolving through a strong focus on innovation.

As part of our innovation efforts, we’re partnering with you, our Blue Plans, to design and deploy a series of pilots in 2016. Our goal is to identify, test and deliver new or improved concepts that help solve market problems and add measurable value for you. Once tested, we can then expand and launch successful offerings across more clients, driving even greater efficiencies.

These pilots will be fueled by the BlueCross BlueShield Venture Fund, which is managed by Sandbox Industries and has been invested in collaboratively by 24 Blue Cross and Blue Shield (Blue) Plans. The goal of this fund is to invest in innovative companies that offer strategic value to Blue plans and help those companies succeed.

At our Client Summit in May, we introduced four pilot opportunities for our owners and clients through an expert-led panel. These pilots will focus on:

  1. Improving adherence for key conditions in a cost-effective manner
  2. Preventing costly non-adherence proactively, before it shows up in claims data — using educational messaging only
  3. Preventing costly non-adherence proactively, before it shows up in claims data — using member incentives
  4. Reducing hospital readmissions through a 30-day, in-home hospital discharge support program

The pilots will range from 6 months to one year, and will begin in 2016. If you haven’t already signed up for one of the pilots, please consider doing so as soon as possible. Prime is still seeking plans to participate in the pilot that focuses on reducing hospital readmissions through in-home, post-discharge support. This type of support can offer a dramatic return on investment and significantly reduce readmission rates.

Providing a 30-day, in-home hospital discharge support program has an average return on investment (ROI) of 3:1 and helps to prevent 30-day readmissions by up to 48 percent.1

Innovation is critical to help you achieving your goals and helping us to fulfill our mission — to help people get the medicine they need to feel better and live well.

These pilots are specific to Prime’s commercial clients.  Our government programs clients recently spent two days together in Denver, CO learning more details about the Innovation agenda for Medicare and Medicaid.

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