How Blue KC measures Spira Care success<\/strong><\/h2>\n\n\n\nBlue KC assesses Spira Care success based on value, quality, and social determinants of health measures.<\/p>\n\n\n\n
Value<\/strong>
The percentage Spira Care has lowered short- and long-term costs for members and employers.<\/p>\n\n\n\n\n- 7.3%<\/strong>2<\/sup> decrease in total cost of care<\/strong> for Blue KC members using Spira Care Centers compared to those using medical homes3<\/sup> in the BlueSelect Plus network.<\/li>\n\n\n\n
- 50.3%<\/strong>2<\/sup> decrease in urgent care visits<\/strong> for Blue KC members using Spira Care Centers.<\/li>\n\n\n\n
- 40.2%<\/strong>2<\/sup> increase in primary care provider visits<\/strong> for Blue KC members using Spira Care Centers.<\/li>\n<\/ul>\n\n\n\n
Quality<\/strong>
Quality metrics in the 100th percentile means Spira Care is performing at the very top compared to peers. In simple terms, more people are getting the preventive care they need, and chronic conditions are being managed better than most providers.<\/p>\n\n\n\n\n- 100th percentile for:<\/strong>
- Colorectal screenings (45-75 years)<\/li><\/ul>
- High blood pressure control (18-85 years)<\/li><\/ul>
- Glycemic status assessment >9% or no value<\/li><\/ul>
- Kidney health evaluation for patients with diabetes (18-64 years)<\/li><\/ul>\n
\n- Adult shingles immunization (50-65 years)<\/li>\n<\/ul>\n<\/li>\n\n\n\n
- 97th percentile<\/strong> for adult Td\/Tdap immunization (19-65 years)<\/li>\n\n\n\n
- 90th percentile<\/strong> for avoiding antibiotic treatment for acute bronchitis (3 months+)<\/li>\n\n\n\n
- 78th<\/strong> percentile<\/strong> for adult flu immunization (19-65 years)<\/li>\n<\/ul>\n\n\n\n
Social Determinants of Health (SDoH)<\/strong>
Spira Care goes beyond treating medical issues alone. Patients are screened for food access, housing, transportation, and other SDoHs. When a need is identified, support is provided within 30 days. This means care teams address real-life factors that can impact health and help remove barriers so patients can stay healthy.<\/p>\n\n\n\n\n- 10 of 10 points<\/strong> achieved for SDoH screening (0-74 years)<\/li>\n\n\n\n
- 10 of 10 points<\/strong> achieved for determining patients with a positive SDoH screen or identified need for food, housing or transportation who received an intervention within 30 days<\/li>\n<\/ul>\n\n\n\n
Questions? Please contact:<\/p>\n\n\n\n
\n- Your Blue KC representative if you\u2019re an employer group broker<\/li>\n\n\n\n
- Your Blue KC Broker Engagement Specialist if you\u2019re an ACA broker<\/li>\n<\/ul>\n\n\n\n
<\/p>\n\n\n\n
1<\/sup>Blue KC members enrolled in plans (without a Health Savings Account) with exclusive access to Spira Care Centers will have no additional cost for any appointment or service provided at a Spira Care Center. Blue KC members enrolled in a plan with a Health Savings Account or HSA eligible with exclusive access to Spira Care Centers will incur a charge for an office visit at a Spira Care Center. Once a member has met their deductible, any future primary care needs at a Spira Care Center are at no additional cost. Preventive services are covered at 100%.
2<\/sup>Data sources for rolling 12 months ending 1\/31\/2026. Risk adjusted.
3<\/sup>Medical home is an approach to providing comprehensive primary care that facilitates partnerships between patients, clinicians, medical staff, and families. It extends beyond the clinical practice and includes specialty care, educational services, family support, and more. American Academy of Pediatrics<\/p>\n\n\n\n<\/p>\n\r\n\t\t\t
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