August 22, 2018

New Product: Blue Distinction^® Total Care Plus Lowers Costs, Improves Health Outcomes (151+ ASO Groups)

Applies to: 151+ large local and national accounts, with ASO funding

The Blue Distinction Total Care (BDTC) program continues to drive down total cost of care trend through coordinated care and performance-based payments. Currently available in all top 100 markets (50 states and D.C.)*, this program is expanding to another designation level: Total Care Plus.

Effective Jan. 1, 2019, Blue Cross and Blue Shield of Illinois (BCBSIL) will launch the Blue Distinction Total Care Plus (BDTC+) program. This new program identifies primary care physicians (PCPs) who demonstrate at least 5 percent to 10 percent lower costs, in addition to meeting the original BDTC quality, efficiency and patient experience criteria.

To maximize this program, a tiered benefit differential product will also be launched on Jan. 1, 2019. The Blue Distinction^® Total Care Plus Benefit Differential product will help employers customize a three- or four-tier benefit design to encourage member utilization of designated PCPs. Those PCPs will coordinate member care and better manage chronic conditions, to help result in an overall healthier member base. By managing the total patient experience, designated PCPs can help reduce health care costs over time and produce savings of $6.71 per average member per month for the employer. 

Availability
The Blue Distinction Total Care Plus Benefit Differential product is available to large (151+) local and national accounts, with ASO funding.

The product can be sold in Illinois, Montana, New Mexico, Oklahoma and Texas. However, currently there are no PCP agreements in Montana, New Mexico, Oklahoma or Texas. Groups in these states can still purchase the benefit differential product if they have members living outside the state.

Product Description
The BDTC and BDTC+ benefit differential products can help you structure your clients’ benefits in a way that may encourage employees to use BDTC/BDTC+ PCPs. Designated providers are committed to improving member well-being through coordinated, patient-centered care, and are rewarded for quality of care rather than the number of services provided.

Sample: Tier 3 and 4 Designs

BDTC+ Benefits

• Drives down the total cost of care
• Better control of chronic conditions like diabetes, asthma and heart disease
• Increases preventive medicine, including pediatric health screenings and immunizations
• Lower hospital admission rates and fewer ER visits
• Helps improve member outcomes
• Provides custom three- or four-tier benefit designs
• Does not require a PCP selection or referrals; however, creates the right incentives to promote better value in the health care system

Product Support

• Provider Finder^® helps members find designated BDTC and BDTC+ PCPs
• Provides employer and member collateral to support thorough promotion and education of the product
• Provides transparency tools to facilitate members taking more active, educated roles in their health care decisions
• Provides pre-analytic and client reporting to identify savings opportunities and provider performance for your group clients

For more information on the Blue Distinction products, contact your BCBSIL representative today. 

*2017 Value-based program RFI – Topline National Stats, November 2017