Focusing on Preventive Care and Chronic Conditions

BCBSMT is an ally to its strong networks of community doctors, hospitals and other providers who deliver care to more than 240,800 members. We employ doctors, nurses, social workers and pharmacists — who help ensure members get access to the care they need.

In 2022, these clinical teams expanded an initiative targeting six areas that have a major impact on quality of life and health outcomes: cancer screenings, childhood immunizations, diabetes, cardiovascular care, behavioral health, and maternal and infant health. “At the base of this is how we get people established with a provider who can have conversations with them about maintaining their health, not illness,” says Dr. David Lechner, BCBSMT’s vice president of health care delivery and chief medical officer.

Simple at-home tests called FIT kits are a noninvasive way to keep up on recommended screenings for colorectal cancer.

Part of the work involves using claims data and other information to identify members in need of recommended services and screenings and facilitate a variety of interventions in collaboration with their providers. The initiative also includes steps to reduce emergency room visits and hospitalizations and to enhance coordination among the doctors and others caring for our members. And to help overcome barriers to care known as social determinants of health, we’re meeting members where they are with programs deeply rooted in our communities.

In 2022, for example, BCBSMT bought retinal cameras and worked with provider groups throughout the state to perform eye exams on members with diabetes, which can damage blood vessels in the retina, causing blindness. In another initiative, BCBSMT offered free at-home colorectal cancer screening tests, fecal immunochemical test (FIT) kits, to targeted member populations to screen themselves for colorectal cancer and return them for analysis.

Building Access to Behavioral Health Care Across Montana

Suicide has plagued Montana for decades, despite broad efforts to raise awareness about risk factors and improve access to mental health services. The state has had the troubling distinction of one of the five highest suicide rates in the nation for 30 years. BCBSMT leaders say it’s critical to become more strategic in coordinating access to life-saving services for members throughout the state — particularly in its most isolated areas. 

BCBMST invests annually to provide a Mental Wellness Basics course to Montana schools at no cost.

To improve access, BCBSMT is working with providers and policymakers to develop care models that will keep members closer to home and reduce obstacles to care, including expanded telehealth services.

The effort is part of a larger initiative to create more medical and behavioral health access and better care management for members no matter where they live.

For example, BCBSMT has identified ways to revise internal credentialing of providers of substance use disorder treatment, potentially increasing access to more intensive outpatient centers statewide.

To help address the state’s mental health workforce shortage, we invested $70,000 in the Rural Behavioral Health Institute and its intervention to prevent suicide among students in grades six through 12. The organization’s bridge psychiatric care model uses a network of trained health clinicians, case managers and providers who ensure students receive proper mental health support or treatment. By the close of the 2022-23 school year, more than 20,000 students across 36 counties will have received the suicide prevention screening intervention. 

“The grant is allowing us to work with more schools, especially rural schools, in more efficient ways to identify kids who need help and make sure they’re getting the care they need,” says Janet Lindow, the organization’s executive director and co-founder. “Their whole life trajectory could be different if they're treated at 14 versus 40.”

The Rural Behavioral Health Institute was among four organizations — along with Friends of Montana PBS, the Logan Health Foundation and the Montana Academy of Pediatric Physicians — that received major grants from BCBSMT’s Big Blue Sky Initiative^SM in 2022 to improve pediatric mental health.

Network Advantage

BCBSMT provides a broad spectrum of coverage options for employers of all sizes, individuals and families, and people eligible for Medicare. In 2022 we maintained our longstanding commitment to offering commercial consumer options in every county in Montana. And for the second year in a row, BCBSMT expanded the reach of its Medicare Advantage offerings, focusing on providing access to care in rural and underserved areas. The expansion brings 2023 coverage options to five new counties.

More than 98% of Montana providers and 100% of Montana hospitals are part of the BCBSMT PPO network. Members also can get efficient and cost-effective health care not only at home in Montana but also when traveling or living anywhere in the U.S.