• October 14, 2008

Success of BCBSND Diabetes Control Pilot Program Leads to Statewide Launch

What started as an experimental pilot program focused on diabetes control now has the potential to positively change the health of all North Dakotans. Blue Cross Blue Shield of North Dakota's (BCBSND) MediQHome quality program will be launched statewide January 1, 2009. The program focuses on giving health care providers the tools and incentives to deliver collaborative coordination of care.

Traditional disease management programs focus on the disease. MediQHome is different because it focuses on the patient and quality of life. Patients select a primary care doctor who becomes their "medical home." That means the doctor keeps track of all that patient's health information, coordinates care with other providers and serves as a single source of information about the patient's condition.

"By changing the way health care is delivered, we can make a huge impact on the coordination of care, and ultimately the health of all North Dakotans," said MediQHome Director Petrice Balkan. "Our pilot project revealed this coordinated approach results in an improved health control for the patient, with a bonus of $500 savings per participant each year."

The innovative program started as an experiment for BCBSND and MeritCare Health System in 2005. During this pilot project, more members with diabetes received recommended care, and emergency room visits and hospital admissions decreased. The savings totaled $500 per participant per year. In September 2007, the pilot program was then expanded to four Fargo MeritCare locations and included more chronic conditions.

Collaboration among the health provider community is critical in the medical home model. Health providers who sign-on to the MediQHome program gain access to the Care Center information tool, the technology that enables the tracking of patients' treatment information. The Care Center tool, created by MDdatacor of Atlanta, Ga., shows recommendations for effective treatment and control of a variety of diseases and conditions, and whether the patient has completed them.

MediQHome providers can use the program and technology for all patients, but will receive a care management fee for BCBSND members with pediatric asthma, adult or pediatric high blood pressure, attention deficit hyperactivity disorder, diabetes, coronary heart disease or chronic heart failure. The Care Center technology will also allow the MediQHome provider to track pediatric and adult immunizations and screenings for colon, cervical and breast cancer.

"MediQHome is being monitored and copied by the Centers for Disease Control and Prevention because of the results we've seen with this collaborative approach," Balkan said. "In addition, our national association and the Harvard Medical School awarded the pilot project a 2007 BlueWorks award, based on improving our members' health and reducing costs."

The entire state of North Dakota is gaining national attention for high-quality, low-cost health care despite what are often considered disadvantages. A small population, large geographic area and lack of health care competition actually foster innovation and collaboration, according to research by the Commonwealth Fund. The Fund's state-by-state scorecard showed North Dakota is above average for access, quality, avoidable use of services, equity and health outcomes.