Letter from the Chief Medical Officer
Dear PEBB Member,
I want to share some highlights about our continuing efforts at Regence to make sure you get the best medical care possible. While some of the things we are doing are not as visible as our continually expanding Web site, myregence.com, or our Regence Health CoachSM and care management programs, they are critically important to us as we do all we can to provide you with reliable health care coverage.
We want your health care to be guided by the best scientific evidence and to meet the standards proven effective in preventing and treating common health conditions.
Here are some of the things we’re doing to continually improve the care you receive:
Evidence-Based Medical Policy
The scientific base for health care is constantly changing. We work with local, regional and national medical experts in every specialty area to review and evaluate the latest scientific evidence and incorporate it into our medical policy. We have the same rigorous process for our development of the Regence drug formulary. This ensures your care is based on the latest and highest medical standards.
Clinical Performance Measurement
We want to help physicians deliver care that meets current standards for preventive care and treatment of asthma, diabetes, high blood pressure and depression. We can accomplish that by promoting evidence-based standards and by measuring clinical performance. The best way to do that is by collaborating with the community to provide more reliable information for the physicians who provide, and our members who rely on them for care. We have partnered with the non-profit Oregon Health Care Quality Corporation in the Aligning Forces for Quality community initiative. Along with other Oregon insurers, physicians, nurses, and patient advocates, we will be working to measure quality and provide those measures to both the public and physicians. Patient and physician feedback helps all of us make sure your care is the best it can be.
Transparency of Information
Transparency is more than the latest health care buzz word; sharing performance information with health care providers and patients is an important way to improve quality. After all, everyone wants to be known as the best in their field, especially physicians. We think information on performance is critical for members who need to make decisions about facilities and providers, so in addition to our work with community partners in Aligning Forces for Quality, we’ll continue to improve our ability to provide you with information and tools such as our hospital quality guide to aid your health decision making. Over the last year, we have asked our members what information they value and know that the experiences of their fellow members is at the top of the list. As a result, we now offer you the opportunity to complete a survey and to make comments about your experience with a provider. We make this feedback available to your fellow members and providers who want to improve care. I’d encourage you to take advantage of this new feature when you visit myRegence.com
Piloting for System Innovation
Finding the right answers means being willing to experiment. Here are some of our partnerships and pilot program efforts:
- Clinical Performance Improvement: In addition to the Aligning Forces for Quality community collaboration, we are supporting ten physician groups in developing tools to improve care. Examples include incorporating registries into new electronic medical records, or developing reminder systems for needed preventive care.
- Patient Satisfaction: We are providing funding to five physician groups to survey patient satisfaction and provide help in improving weaknesses in performance. We also have new tools to gather your input and make it available to other members.
- Behavioral Health Integration and Quality Improvement: Although we are making system-wide improvements, we are also planning to work more intensively with physician groups to test new ways to integrate, monitor and improve care. We are also working with providers to monitor performance and outcomes through patient surveys and provider feedback. We want to make sure we can help our members identify the most effective providers.
- Medical Homes: We are working intensively with two large physician groups to provide supportive team based care which provides the best chronic and preventive care along with integrated behavioral health. Supporting physicians to improve their model of care and work for continuous improvement is, we believe, a good investment for our members.
- Reimbursement Transformation: We want to develop new provider reimbursement models that encourage and reward the best care for you. We will also want to provide you with useful information about the costs of care so you can make the best value choices possible. Everyone agrees there are problems with what we have now, but it will take new ideas and models to improve it, and we are developing the team and the innovations we need to lead those changes.
We’re here to ensure that you receive the highest quality of care. That’s why we’re forging partnerships with our members and providers to transform the health care experience. We are grateful for the privilege to serve you.
Dr. Ralph M. Prows
Chief Medical Officer
Regence BlueCross BlueShield of Oregon