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BCBS Ups its National Data, Care Coordination Game

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   November 03, 2015

A pair of announcements from the Blue Cross Blue Shield Association demonstrates its commitment to arming employers, providers, and members with a great wealth of quality and cost data to inform their healthcare decisions.

The 105 million members of the Blue Cross Blue Shield (BCBS) organizations across the U.S. represent a data set too often unanalyzed and underutilized. But two recent announcements indicate that the 36 independent Blues are bringing their health insurance businesses into closer alignment, powered by a vast increase in useful, shared data.

Maureen Sullivan

The Blue Cross Blue Shield Association (BCBSA), the federation linking all 36 Blues, in late September, announced BCBS Axis, a data service aggregating 2.3 billion procedures conducted annually from more than 20,000 healthcare facilities and 540,000 physicians.

In late October, BCBSA announced Blue Distinction Total Care, a program for employers that emphasizes prevention, wellness, disease management, and coordinated care while reducing costly duplication and waste in care delivery. The 36 independent Blues all committed to offer Total Care as a nationwide network of offerings.

BCBS Rolls Out 'Total Care' National Network

These two announcements have a thread of connection. The Blues will use BCBS Axis as the data mechanism by which medical professionals can be benchmarked and designated for the Total Care network.

To understand Axis better, I recently spoke with Maureen Sullivan, senior vice president of Strategic Services and chief strategy officer for BCBSA. The transcript below has been lightly edited.

HLM: What does BCBS Axis represent in terms of the journey BCBS has been on to bring all its data into more a usable, actionable form?

Sullivan: There's been a commitment from every [BCBS] CEO stepping up and providing data across every zip code. When you look at the spend on the transparency tools, we've quadrupled the number of treatment categories that are available. What that means is, that for our national employers, for our members, and for our provider partners, they'll have a greater wealth of data to draw on, to inform their decisions.

HLM: How will this help providers?

Sullivan: Axis actually powers what happens at the local BCBS plan level. So when a BCBS plan [offers] benchmarking information to the providers, what they want to be able to show is not only how a certain condition is being treated, and what the outcomes are, and what the costs of episodes are within the state, but comparing it more broadly to other like markets. This gives the type of data depth to be able to do that.

Scott Mace is the former senior technology editor for HealthLeaders Media. He is now the senior editor, custom content at H3.Group.

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