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  • December 3, 2009

BCBSND wins BlueWorks award for disease management

Blue Cross Blue Shield of North Dakota's Advanced Medical Home Program has been honored by Harvard Medical School's Department of Health Care Policy and the national Blue Cross and Blue Shield Association. The program won a 2009 BlueWorks award for its innovative approach to disease management.

"Awards and programs like this reaffirm the high quality of health care provided in North Dakota," said Dr. Jon Rice, senior vice president and chief medical officer at BCBSND. "As the country strives to find solutions to rising health care costs, it is great to have a laboratory that is nationally recognized right here in our own state."

BCBSND's original pilot program with MeritCare Health Systems, known as the Provider-Based Diabetes Disease Management Pilot Program, won a BlueWorks award in 2007. BCBSND and MeritCare later transformed this program into the Advanced Medical Home Program, expanding the program to four MeritCare sites and adding hypertension and coronary heart disease patients.

BCBSND and MeritCare collaborated to determine whether hypertension and coronary heart disease, when managed by health care providers, would result in improved clinical outcomes and fewer trips to the emergency room and inpatient admissions, according to Dr. David Hanekom, medical director at BCBSND.

Preliminary results from the first year of the two-year program indicate significant improvement in clinical outcomes as well as process measures and patient access. However, no significant changes occurred in emergency room or inpatient admissions.

Hanekom noted the results for diabetes in the Advanced Medical Home Program remain positive. The coronary heart disease members had the highest average risk per member.

Compared with diabetes and coronary heart disease, hypertension is a relatively low risk factor by itself. Hanekom said the study's unexpected finding was that many of the hypertension patients—without known diabetes or coronary heart disease—had heart attacks and strokes in the first year of the study. Because of those unanticipated complications and expenses, the return on investment for the entire study population was negative at $605 per member.