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(for members only)
Mountlake Terrace, WASHINGTON - (November 19, 2012) - Premera Blue Cross was recognized by the Blue Cross Blue Shield Association for winning two 2012 Best of Blue Awards in the categories of Clinical Distinction and Member TouchPoint Measures. The Best of Blues Awards program encourages health plans to identify and share innovative processes and activities with other health plans to support the enhancement of the Blue Cross Blue Shield brand nationwide. Premera, along with 28 other Blue Plans across the country entered the competition and Premera was successful in securing two of the nine awards. All entries were subject to a rigorous criteria-based process and were judged by industry experts at the Harvard Medical School Department of Health Care Policy.
“We are honored to receive this prestigious recognition from Harvard and the Blue Cross Blue Shield Association,” said Roki Chauhan, MD, senior vice president and chief medical officer at Premera Blue Cross. “There are many obstacles to overcome when it comes to slowing the rising costs of healthcare in our country, and both of the programs Premera was recognized for address these challenges. Each program delivers both health and economic advantages to consumers and are steps in the right direction toward creating a sustainable healthcare system.”
Premera was recognized in the Clinical Distinction category for its Value-Based Formulary pharmacy design, which uses medical research to evaluate how well drugs work, how much they cost and how their cost and effectiveness compare to similar drugs used for the same condition. Drugs with the least proven value shoulder a larger cost share while drugs with proven effectiveness and higher value are more affordable.
“Premera’s value-based formulary still provides members access to the medications they need while helping them get the most healthcare benefit from their healthcare dollar,” said John Watkins, pharmacy manager for Clinical Services at Premera Blue Cross. “Receiving the Clinical Distinction Award is an important milestone for this formulary, as it provides validation of the concept by an outside expert panel of judges.”
Premera moved to this value-based formulary design in 2010 to address rising pharmacy benefit costs and encourage the use of drugs with proven benefits. It was the first plan in the nation to offer this type of comprehensive value-based formulary and it has already proved to be successful. The company has seen an 11 percent cost savings in its first year of implementation.
“Premera’s value-based formulary is one small way to put the consumer in the driver’s seat,” said Chauhan. “If we give consumers the information to make wise trade-offs, and an economic reason to care, they will transform our healthcare system.”
Premera also won the Member TouchPoint Measures Award in the category of Claims Adjudication for its Gemba Hour program. Premera’s Gemba Hour program was developed as a result of the work Premera has done with Lean in order to improve efficiencies within operations. In Lean terms, Gemba is the place where the work is done and Premera’s Gemba Hour builds relationships between managers and employees, provides an avenue for Lean education and also improves processes. The Gemba Hour was implemented in 2011 as part of Premera’s long history of using Lean to improve efficiencies and remove waste from the system.
“The results from Gemba Hour have been quite remarkable,” said Doris Jeffries, manager for Customer Service, Membership and Billing at Premera Blue Cross. “For instance through the use of Gemba Hour, we have improved our claims processing time for one of our largest clients by five percent. This improved turnaround time means that members have to spend less time inquiring about the status of their claims, resulting in a better overall customer experience.”
Premera Blue Cross is a leading health plan in the Pacific Northwest, providing comprehensive health benefits and tailored services to more than 1.5 million people, from individuals to Fortune 100 companies. Premera is committed to providing its members peace of mind about their healthcare coverage. The company offers innovative health and wellness solutions focused on quality outcomes for patients and controlling costs. Premera Blue Cross, which has operated in Washington since 1933, is a not-for-profit, independent licensee of the Blue Cross Blue Shield Association. Premera Blue Cross is a member of a family of companies based in Mountlake Terrace, Wash., providing health, life, vision, dental, stop-loss, disability, workforce wellness and other related products and services. The family of companies employs approximately 3,000 people and provides healthcare coverage and related services to nearly 1.7 million members. Please visit www.PremeraNews.com for more information.
¹Source: Premera’s 2011 internal data analysis