Value-Based Specialty Care and Our Customers

  • January 17, 2019

    When patients pay too much for care, we all feel the impact. Our employer groups are asking us to help them slow the increase in health insurance premiums. Our members are asking us to find solutions that provide better quality outcomes at a lower cost and large groups like Boeing and Walmart wanting to reduce their healthcare cost spend. For these reasons, Premera is partnering with providers to help deliver high-quality, cost efficient care for our customers.

    Why is Premera focusing on quality and cost variance?

    We all want our customers to be back on their feet as soon as possible. We don’t want them worrying about taking more time off from work and a second recovery. Ultimately, we all want our patients to go to high-quality providers and have great outcomes with a great experience. Premera’s customers want to know that they are paying a fair price for the quality care that they receive. We want to empower our customers to make the best decisions around where they receive care and one of these factors is cost. This is especially true for customers with high-deductible plans.

    Centers of Excellence

    Many groups and insurers are turning to Centers of Excellence for specialty care procedures like spine surgery or knee replacements. These designated facilities have strong quality outcomes at a fair price which is good for patients, the providers and the employers. Centers of Excellence are typically chosen for procedures known to have significant variance in cost and quality from provider to provider even in one community. This includes the areas of oncology and surgery for joint replacement, bariatric, spine and cardiac conditions.

    Blue Distinction Specialty Care Program

    At the end of the day, we want to make it simple and easy for our members to get access to high-quality, cost efficient specialty care wherever they live. Premera has partnered with other Blue Plans across the US and the Blue Cross Blue Shield Association to develop the Blue Distinction Specialty Care program.

    The Blue Cross Blue Shield Association Blue Distinction program, identifies providers who are high quality with a Blue Distinction Center (BDC) designation and providers who are high quality and cost efficient with the BDC+ for specific specialties. Our customers see these designations when searching for providers in our find-a-doctor tools and we are actively educating members on the value of Blue Distinction Centers.

    Interested in learning how you can become a designated Blue Distinction Center? Contact Carolyn Schauble at for more information or BCBSA.

    This article is the third part of a series dedicated to understanding value-based healthcare (part one and part two).

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