Reducing costs, improving outcomes
Healthcare costs continue to go up, driven in part by higher-cost medical claims and expensive prescription medications. Employers are looking for new strategies to help manage total cost of care and improve employee health outcomes.
BCBSRI’s care management program uses a proactive, data-driven approach across the healthcare continuum—promoting preventive services, addressing the most prevalent and costly chronic conditions, and providing personalized support for complex health needs. Targeted interventions like these may help reduce hospital readmissions, prevent unnecessary ER visits, and decrease disease-related complications, all of which ultimately helps reduce overall costs and improve health outcomes.
Wellness and prevention
$0 preventive care helps members stay healthier and supports earlier identification of health issues, which can mean more treatment options, lower total costs, and better outcomes.
- $0 well visits and recommended cancer screenings and vaccinations are included in all fully insured health plans.
- BlueCare Connect provides personalized care reminders and relevant health recommendations for members—and can help them locate providers and schedule appointments.
- Targeted member outreach—via email, text, and phone—helps close gaps in care, such as overdue mammograms or missed colonoscopies.
- Health and wellness tips, including nutrition, fitness, and stress management, are available on our Rhode Ahead member education site.
Chronic condition support
Chronic conditions are the leading cause of illness, disability, and death in the United States, according to the Centers for Disease Control and Prevention (CDC). The CDC estimates three in four Americans have at least one.
Earlier identification of at-risk individuals—along with targeted and personalized support services—can help members manage their health more effectively and, in some instances, slow or even reverse disease progression. BCBSRI offers third-party and internal programs to address specific conditions, including:
- Joint health and musculoskeletal (MSK) care*
- Diabetes and prediabetes*
- Heart health
- Chronic obstructive pulmonary disease (COPD)
Complex care management
With care managers, employees don’t have to face serious health challenges alone. We can help them manage both their physical and emotional needs and, where appropriate, help them find quality care options closer to home. Our programs address conditions such as:
- Cancer
- Behavioral health and substance use disorder
- Women’s health and high-risk maternity
- Kidney disease
Care management at home
HouseCall by Blue delivers 24/7 complex care support, including Rx, social, and behavioral health needs, delivered in the comfort of home. Members can speak with a specialized care team by phone or video around the clock. Urgent home visits are available as needed. Designed to complement regular care, HouseCall by Blue services might even reduce the need for certain medical appointments or hospitals—saving time and money and minimizing inconvenience to the member.
Speak with your broker or account executive to learn how our suite of care management solutions can help your employees.
*Available to self-funded groups for additional fees