• June 16, 2009

BCBSND receives Provider's Choice Award from Health Department

Blue Cross Blue Shield of North Dakota received the 2009 North Dakota Immunization Provider's Choice Award from the North Dakota Department of Health.

The award recognizes "individuals, businesses and organizations that have made extraordinary contributions towards improved adult and/or childhood immunization rates in the North Dakota," according to the Health Department.

The Health Department said BCBSND was nominated for the award because of the company's support of "first-dollar coverage," meaning there are no deductibles, copays or coinsurance amounts.

"First-dollar coverage eliminates any barriers for not getting what is the most cost-effective preventive service that we have," said Dr. Jon Rice, senior vice president of Medical Management and Chief Medical Officer at BCBSND. "It also makes coverage and understanding coverage easier for members and providers."

Another factor was the company's participation on the Immunization Advisory and PROtectND committees. The Immunization Advisory Committee, which also has members from the Health Department, provider groups and public health units, makes decisions about how to improve the state's immunizations systems and results.

PROtectND is a day-to-day operations group for immunizations in North Dakota and includes representatives from public health units, private providers, BCBSND and the Health Department. PROtectND has helped with building and testing the new billing system for immunizations and has assisted with the transition from a universal vaccine state to a "vaccines for children (VFC) only" state.

Before 2008, the Health Department provided nearly all vaccines for North Dakotans. In 2006 and 2007, BCBSND reimbursed the Health Department for vaccines for BCBSND members.

When North Dakota switched to VFC—meaning the state only provides vaccines for Medicaid participants and uninsured and underinsured citizens—providers and public health units had to develop purchasing and billing mechanisms for vaccines for insured patients.

"This was not a problem for our private providers, but the public health units did not necessarily have capabilities and staff," Rice said. BCBSND made the public health units participating providers and gave them access to The Healthcare Online Resource (THOR) so they could determine benefits.

BCBSND also developed a billing mechanism that is part of the North Dakota Immunization Information System. The billing mechanism allows public health units to generate bills when vaccines were entered in the system, a state law requirement. This eliminated duplicate entry and saved the public health units the expense of buying billing systems.

"We think that our actions have gone a long way to stabilize a vaccination system that had the potential to become very shaky, inefficient and disjointed with the conversion from universal to VFC only," Rice said.