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Collaborating with providers to help members close gaps in care and achieve optimum health.

Focusing on Preventive Care and Chronic Conditions

Blue Cross and Blue Shield of Illinois (BCBSIL) is an ally to its network providers who deliver quality care to its more than 8.8 million members. To fulfill that promise, it employs about 1,000 clinicians, including doctors, nurses, social workers and pharmacists, who help ensure members get the care they need. 

Last year, the company expanded an initiative aimed at closing gaps in care by targeting preventable conditions that most affect members’ health and well-being. BCBSIL focused on six areas of health — cancer screenings, immunizations, diabetes, cardiovascular care, behavioral health and maternal and infant health — to help nudge members to get recommended preventive screenings and manage chronic conditions.

Research published in the American Journal of Managed Care shows early disease detection enables prompt treatment that can prevent disease progression and poor health outcomes.

“We offer a unique perspective on the health journey of our members,” says Dr. Derek J. Robinson, BCBSIL’s chief medical officer. “Our BCBSIL clinicians and health professionals are aligned with the mission of promoting the health and wellness of our members, in collaboration with their health care team.”

Part of the work involves using claims data and other information to identify members in need of recommended services and screenings and informing members and providers about those gaps by letter, email, phone or text message.

“For a variety of reasons, preventive care and immunizations recommended by a doctor’s office might not get completed,” Robinson says. “Through our member-centric focus on quality, our data analysis can present an opportunity for our team to connect directly with a member or send a reminder to their health care team that a screening mammogram or colonoscopy is past due. Working together, we can continue to improve health outcomes in all communities.”

For example, last year, BCBSIL and its South and Westside Blue Door Neighborhood Centers (BDNC) started a three-year colon cancer screening initiative. They partnered with the American Cancer Society, Colorectal Cancer Alliance, Gilda’s Club and Sinai Chicago. The Morgan Park and Lawndale centers, located in some of Chicago’s most underserved ZIP codes, held events where medical experts and colon cancer survivors educated residents about the disease and explained the importance of early screening and diagnosis.

Those who attended the events participated in healthy-cooking and exercise demonstrations. They also were offered free at-home colorectal cancer screening tests, fecal immunochemical test (FIT) kits, an effective and less invasive screening for colorectal cancer.

“The audience was very interested in the survivor stories,” says Laron Taylor, BDNC director. “They had many questions about the symptoms and were very interested in hearing their experiences with overcoming colorectal cancer.”

In separate initiative, BCBSIL offered FIT kits to targeted retail members to screen themselves and return the kits for analysis. We sent FIT kits to 17,530 eligible members, and 2,616 performed the screenings. We recommended 153 members schedule colonoscopies because their FIT kit results were abnormal.

“Colorectal cancer screening should be on the to do list for everyone,” Robinson says. “We can actually prevent cancer from occurring through early screening.”

A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association