CHICAGO — Blue Cross and Blue Shield of Illinois announced the results of nearly 12 months of real-time “ADT” (“Admission, Discharge and Transfer”) data-sharing with Illinois Health Partners, an affiliate of NorthShore-Edward-Elmhurst Health with more than 600 physicians based in suburban Chicago.
BCBSIL reviewed 30-day readmission rates and found IHP’s adjusted rate of readmission dropped from 15.9% in the first half of 2021 to 13.5% in the first half of 2022 due to IHP’s efforts to align care management protocols with analytics software that identifies patients who may need transitional care management.
In an additional analysis, the team compared 2022 IHP readmission performance to the 2022 readmission performance of all BCBSIL Illinois Accountable Care Organizations by performing a one-to-one match between admitted patients, based on member demographics, chronic diseases, and social determinants of health. This showed IHP’s overall readmission rate was 3.2% lower than the readmission rate of the matched ACO cohort.
With IHP leveraging sophisticated analytics software coupled with its care management staff, IHP helps to meet patient needs, including primary care provider (PCP) interventions and appointments, wellness appointments and care, medication reviews, and help from a care coordinator.
“Actionable analytics are essential to advancing value-based care,” said Jeslie Jacob, division vice president, Provider Performance, BCBSIL. “IHP’s use of this analytics software to prevent readmissions and hospitalizations is a tangible example of us working together to improve member outcomes using the power of technology and teamwork.”
Teri Kaneski, BSN, system vice president, Physician Engagement and Value-Based Care Performance for NorthShore-Edward-Elmhurst Health, added, “our commitment to care includes technology that can help us deliver better health outcomes for our patients and communities. Analytics can guide doctors and nurses to higher-risk populations so we can provide higher quality care, better patient experience and more cost-effective care by minimizing hospitalizations and rehospitalizations.”
This analytics software technology is one of several new technologies being applied by Blue Cross and Blue Shield of Illinois to improve quality outcomes in health care and reduce unnecessary costs. Successful technology pilots can lead to wider deployment of technologies, improving the effectiveness and efficiency of health care delivery.
About Blue Cross and Blue Shield of Illinois
Blue Cross and Blue Shield of Illinois is the largest health insurer in Illinois, serving 9 million members and operating in all 102 Illinois counties. In 2022, J.D. Power named BCBSIL #1 in Member Satisfaction among Commercial Health Plans in the Illinois/Indiana Region. BCBSIL is a division of Health Care Service Corporation, a Mutual Legal Reserve Company and an Independent Licensee of the Blue Cross and Blue Shield Association.
About NorthShore-Edward-Elmhurst Health
NorthShore – Edward-Elmhurst Health is a fully integrated healthcare delivery system committed to providing access to quality, vibrant, community-connected care, serving an area of more than 4.2 million residents across six northeast Illinois counties. Our more than 25,000 team members and more than 6,000 physicians deliver transformative patient experiences and expert care close to home across more than 300 ambulatory locations and eight acute care hospitals – Edward (Naperville), Elmhurst, Evanston, Glenbrook (Glenview), Highland Park, Northwest Community (Arlington Heights), Skokie and Swedish (Chicago) – all recognized as Magnet hospitals for nursing excellence. Located in Naperville, Linden Oaks Behavioral Health, provides for the mental health needs of area residents.