Programs

We offer a wide range of programs and resources
designed to support our members at any stage of health.
  • BlueCard Program

    BlueCard® is a national program that enables members of a Blue Cross and/or Blue Shield Plan (Blue Plan) to obtain health care services while traveling or living in another Blue Plan's service area. Regence is part of the BlueCard national program.

  • Cost and quality

    We believe that sharing cost and quality data with our members helps them make more-informed health care decisions. Our member website includes several online tools designed to give our members the information they need. Our cost and quality programs include:

    • Community collaboratives
    • Cost estimator
    • Patient reviews
    • Quality Program
  • Medical management

    Our medical management programs are either targeted to specific conditions or designed to improve or maintain overall health. Programs include:

    • Care management
    • Diabetes management
    • Member programs
    • Personalized Care Support (palliative care)
    • Physical medicine
    • Radiology program
    • Sleep medicine
  • Pharmacy

    Pharmacy Services assists our providers and members with prescription benefits and other relevant information.

    • Learn more about our special member programs and view pharmacy resources.
    • View pharmacy prior authorization and Preferred Medication List / Formulary information.
  • Medicare Quality Incentive Program

    This program is designed to reward providers who ensure that identified medical care or diagnosis gaps for Medicare Advantage patients are addressed and closed each year. Learn about member gap reports, calculating incentives and receiving payment.

  • Medicare Star Ratings

    The Centers for Medicare & Medicaid Services (CMS) assigns Medicare Advantage plans with a quality rating on an annual basis using a five star rating system. Learn how you can influence star ratings.

  • Risk Adjustment program

    Risk adjustment is designed to encourage insurers to compete on quality and efficiency, preserve consumer choice and improve quality of care for patients. Risk scores for members are calculated differently for Medicare and commercial members, but the information required from providers and office staff is the same.