Value-Based Care: Smarter Care for Better Health

Blue Cross and Blue Shield of Oklahoma (BCBSOK) is committed to setting up value-based payment arrangements with health care providers that promotes care leading to better outcomes, all for a reasonable cost.

Our approach to developing value-based care payment arrangements is helping shift health care's focus from paying for more services to paying for better care and outcomes.¹

The value-based care models are designed to:

Incentivize doctors and hospitals when they help members improve their health by achieving better health outcomes
Focus on efficent care (or reducing wasted resources) that may lower employer group health care costs
Improve the health care experience for members
Increase collaboration among health care providers to reduce fragmentation or ineffective coordination

At BCBSOK our goal is to develop ways to help our contracted providers improve health care and reduce the overall costs of care. Our value-based care models show our evolving steps for balancing quality and affordability.

Saving with BCBSOK Value Based Care
Our cutting-edge contracted provider arrangements work to lower total spending by:
- Increasing Accessibility to Patient History
  We've built tools that pull two years' worth of claims history data at a time.² This gives contracted health care providers a clearer picture of treatments their patients have — or haven't — completed within the two year period.
- Tailoring Specialty Care Costs
  Group health care benefits programs can be adjusted to help meet cost objectives. For example, employee copays may get lowered when visiting Blue Distinction Centers^® and Blue Distinction Centers+^SM.
- Making Health Care More Accountable
  BCBSOK works with contracted providers to create a team-based, primary care approach that aims to offer the right care at the right time.
- Measuring Performance Results
  - We use data to:
    
    Measure success
    
    Provide financial incentives to providers
    
    Encourage clinical and quality performance
This helps us toward our goal to increase quality and lower the overall cost of care while helping members stay healthy and productive.
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For additional information about primary care Value Based Care* and payment, please contact:

BCBSOK Value Based Care Network Consultant:
Patrick Hutton, PhD, at 918-551-2045 or email Patrick
or
BCBSOK Clinical Practice Liaisons:
Dianna Gorniak, RN, at 918-551-2535 or email Dianna
Vicki Curtis Ragland, RN, at 918-551-2546 or email Vicki

*Blue Cross Blue Shield of Oklahoma does not guarantee Value-Based Care arrangements with all doctors and/or hospitals, but evaluates requests on a case by case basis to determine if the potential impact meets market needs.

¹Prior results are not a guarantee of any future results and individual results may vary. The programs are tools to assist the independently contracted providers in rendering care to members. The final decision about any health care service or treatment is between the member and his or her health care provider.

² The data includes only those claims that have been paid by BCBSOK.

Related Resources

Value-Based Care: Smarter Care for Better Health

Saving with BCBSOK Value Based Care

Offer Smarter Care for Better Health