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Quality

Satisfaction

Efficiency

Bringing You More Than Ever BeforeLVBCH • June 23, 2015

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Partnering in TransformationWe share the same vision and mission in transforming the health care marketplace

LVBCH

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Exceeding Triple Aim – Our Approach

• Value-based programs

• Realigning the delivery and payment models

• Innovation

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Delivering Excellence

Capital Advantage Assurance Company®

Commercial PPO; Marketplace PPO – Accredited

Capital Advantage Insurance Company®

Marketplace PPO – Accredited

Keystone Health Plan® Central Marketplace HMO – Accredited

Since the last eValue8 submission, Capital BlueCross has achieved PPO accreditation from NCQA. Our product accreditations include:

Keystone Health Plan Central Medicare HMO – Excellent

Capital Advantage Insurance Company Commercial POS – Commendable

Keystone Health Plan Central Commercial HMO – Commendable

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Capital BlueCross’ Clinical Care Continuum

Total transparency for providers, payers, and employers

TheonSM is a product of Geneia® LLC. On Behalf of Capital BlueCross, Geneia LLC provides health data informatics and analytical support and services. Geneia LLC is an independent company.

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Improving Outcomes at Reduced CostPatient-Centered Oncology Pilot Program (PCOPP)

• Focused on developing and implementing a strategic approach, aligning financial incentives to improve delivery and outcomes of cancer care

• Encourages practices to improve care and lowers costs through an episode-based model

• Collaborative approach between payer and physician, allowing Capital BlueCross to measure, transform, and increase quality (HEDIS) of cancer care

Capital BlueCross has seven Accountable Care Arrangements (ACAs)

• Five full ACAs that during the term of the agreement include escalating risk sharing between the organizations and include 557 physicians and 80,000 attributed lives

• Two mini-ACAs that support nonintegrated community physicians in York and Adams counties that include 165 physicians and 13,000 covered lives

• Looking ahead, our goal is to double our ACA membership

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Provider and member-level actionable data and insights to identify and care for patients and populations

Investing in Innovation for Transformation

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Technology that supports the transformation strategy and drives action

• Unified analytics• Singular source• Simple user interface• Embedded care collaboration tool• Integrated remote patient monitoring

The Power Behind Our Programs

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Improving Care and Outcomes“The reason St. Luke’s University Health Network and Capital BlueCross formed this Accountable Care Arrangement (ACA) was to try to increase the quality of care for our patients, and to lower the cost of health care for patients and employers.

Launching the ACA means that Capital BlueCross can access data to see how patients are doing from a metric and quality perspective. Each month, we hold a case review in which we discuss patients considered to be high risk, those needing preventive services for health maintenance such as mammograms or colonoscopies, those who have been discharged from facilities, and so forth. This helps to avoid duplication of services while monitoring progress toward meeting individual health care needs.

We agree with Capital BlueCross when it says that our relationship is strong because our access to data, direct contact, and regular communication produce better outcomes for our patients. It has been a great partnership.” 

- Linda Gately, Associate Vice President, St. Luke’s Physicians Group

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Engaging Your Members

• Health Education and Wellness

• Worksite Wellness• Capital Blue• In-person Health,

Wellness, and Service • The Member

Experience and Member Tools

• Search & Save Center

• Personal Profile• Digital Health

Coaching• Telehealth

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The American Customer Satisfaction Index (ACSI) is the only national cross-industry benchmark of customer satisfaction of its kind.

Capital BlueCross scored highest among health insurers, significantly exceeding the industry average.

Capital BlueCross

Industry Average

60 70 80

78

70

Industry Leader in Customer Satisfaction

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Questions?

For additional information, visit: capbluecross.com/LVBCH

Thank You for Your Time!

Capital BlueCross and its subsidiaries, Capital Advantage Insurance Company®, Capital Advantage Assurance Company®, and Keystone Health Plan® Central, are independent licensees of the BlueCross BlueShield Association.