July 2018

Update: 2018 Quality Improvement Program Description and Work Plans

Blue Cross and Blue Shield of Texas’ (BCBSTX) core values of Caring, Integrity, Respect, Commitment and Excellence support our purpose:

To do everything in our power to stand with our members in sickness and in health^®.

We align our values and purpose through program planning that aims to reduce health disparities for the populations we serve.

Review our 2017 accomplishments below, as well as our opportunities for improvement in 2018.

2017/2018 Accomplishments

• Continuous provider engagement via:
• Monthly articles in Blue Review
• HEDIS^® training
• Case Management/Disease Management collaboration to reduce potentially preventable events and encourage use of primary, preventive care
  
• Implementation of critical incidents reporting with oversight meetings and reporting to maintain and increase member safety and continuity of care
  
• Implementation and continuation of performance improvement projects (PIP) including:
  
• 2017: Improvement of well-child visits for the first 15 months of life for the STAR and Children’s Health Insurance Program (CHIP) populations
• 2017: Screening Assessment Instrument completion and population assessment for STAR Kids
• 2018: Improved the timeliness of prenatal and postpartum visits for the STAR population
• 2018: Reduced the rate of potentially preventable emergency department visits for upper respiratory infections for STAR Kids
• 2018: Improved the rate of Weight Assessment, and Counseling for Nutrition and Physical Activity for the CHIP population
  
• Successful implementation of STAR Kids (2017 is full baseline year)
  
• Continuous collaboration, and alignment of goals and strategies with medical health homes
  
• Additionally, BCBSTX scored a 99.1 percent on our 2016 annual evaluation for Quality Assessment Performance Improvement, which demonstrates continued improvement for BCBSTX Medicaid (STAR, STAR Kids) and CHIP.

Looking Ahead in 2018
Moving forward, BCBSTX is committed to improving member safety and continuity of care. We recognize there are opportunities to improve care, and continue aligning our purpose and goals, including:

• Texas Health Steps: Monthly oversight will continue with trending and tracking of data and reporting to increase utilization
  
• Improving continuity of care and care coordination: Opportunities will be identified and analyzed across settings and between practitioners
  
• BCBSTX will continue implementing programs that address Population Health Management, social determinants of health and health equity with analysis of data to support programs, interventions and effectiveness for quality, affordable care.
  
• Behavioral health programs will be evaluated to ensure alignment of PIP interventions and initiatives to include pay-for-quality measures, medical health homes and quality improvement strategies.

For more information on our 2018 opportunities, please contact:

Our success is your success and we thank you for your partnership in serving BCBSTX members.

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