Blue KC Is Focused On Value-Based Care

Greg Sweat, M.D. — March 3, 2020

At Blue KC, we recognize that change is necessary in the healthcare field to continually serve our members in the most effective ways possible. Recently, these changes have driven us to further invest in value-based care practices across our network.

Value-based care programs offer monetary incentives to healthcare providers for quality outcomes rather than volume of service. In turn, these efforts result in better quality care at lower costs for our members. Two of our most effective value-based care programs include our Advanced Primary Care Home Model and Spira Care.

Incentivizing Quality Care with Medical Homes

Nine years ago, we introduced our Primary Care Medical Home (PCMH) program. Our Medical Home program was designed following a value-based model to effectively manage healthcare spending while providing high-quality healthcare to patients. To achieve this goal, we have incentivized providers based on high-quality healthcare to patients — not on the volume of patients seen. Our Medical Home program has evolved to an advanced primary care model, which furthers its value in areas such as improving social determinants of health, and Blue KC is proud to be a leader in this field.

Our Medical Home program currently comprises 854 physicians practicing at more than 200 different locations throughout the greater Kansas City metropolitan and surrounding area. These dedicated providers care for more than 370,000 Kansas Citians. We continue to see that our members who receive care through a Medical Home continually outperform non-Medical Home members. Each year, these members show improvement in diabetes care, major depression and asthma. Here is a preview of Blue KC’s 2018 results: 

These results leave us hopeful for the future of this ever-growing program as we work toward a future where the quality of care is always the top priority for healthcare providers. But our Medical Home program is not the only Blue KC initiative spearheading our efforts to streamline value-based care and continually evolve.

Redefining Primary Care with Spira Care

In the years following the inception of the Medical Home program, we continued to work toward a future where value-based care is the default care patients receive. This led to the creation Spira Care.

Spira Care was designed around what we know our members truly want from their health plan — human interaction and human connection within their healthcare experiences. The program exists as a combined primary care and insurance offering that gives eligible Blue KC members simple, seamless access to healthcare. At its core, Spira Care simplifies the healthcare experience. Its integrated primary care model is built on the promise of a stress-free member experience that enables stronger relationships with primary care providers.

In addition to its core goal of simplification, Spira Care addresses four of the key challenges that exist in the current healthcare landscape: experience, simplicity, quality and cost.

To better meet the expectations patients have when it comes to their healthcare experience, all Spira Care locations offer extended hours, telehealth and a wealth of options for alternative forms of communication. To simplify health plans, there are no copays, no deductibles and low or no cost for any care provided at Spira Care Centers. Of course, quality of care is top of mind at all Spira Care Centers. The Care Team approach streamlines the coordination of care for each patient, keeping care intuitive and personal. Lastly, Spira Care is designed to create savings for members and employers by combining patient-centered primary care with the high-performance BlueSelect Plus network.

Currently, there are seven Spira Care Centers open to Blue KC members across Kansas and Missouri. The Crossroads, Lee’s Summit, Liberty, Olathe, Shawnee, Tiffany Springs and Wyandotte are all home to a Spira Care Center. To experience Spira Care from the comfort of your home, take a virtual tour of a Care Center.

Looking Toward the Future of Value-Based Care

Our goal with these programs is to not only to meet the needs of our members, but to exceed them. We want to continue to exist at the forefront of positive change within the healthcare industry as we move it forward to better serve our members through value-based care.

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