Montana Medicare Advantage Information and Forms
Healthy Montana Kids Plan (HMK)
Medicare - Noridian Administrative Services
Montana Rural Health Initiative
Electronic claims information is available at availity.com
Blue Patient Safety Toolkit
The Blue Cross and Blue Shield Association (BCBSA) has launched the Blue Patient Safety Toolkit to provide tools, resources, and industry best practices that may be used by providers to assist with improving safety. The Toolkit focuses on four critical areas.
Hospital Board Engagement
Responsibility for making patient safety the number one priority of every person who works in their facility lies with the hospital board. Hospital boards of directors are able to initiate and sustain change by holding everyone in their organizations accountable for improving patient safety. This includes setting and measuring high standards. By implementing a zero tolerance policy for adverse patient outcomes, hospital boards send a clear message that the status quo is unacceptable.
Many Blue Plans are starting to put quality measurement into hospital agreements, quality recognition programs and/or pay-for-performance programs. A major characteristic of quality is safety and protection of our members from harm. Adverse events, complications and medical errors are costly in terms of lives and dollars.
Improving the safe use of medication has been identified as a key strategic initiative by the National Council of Physician and Pharmacist Executives (NCPE). The Blue Cross and Blue Shield Association (BCBSA) urges all Plans to make the reduction of the medication errors a high-priority, with the goal of reducing medication errors in both hospital and outpatient settings.
Historically, improving medication safety has been a difficult undertaking with many failed attempts to improve care, though some efforts, such as electronic prescriptions, have shown modest gains in safety.
When used appropriately, medications are one of the most cost-effective tools that medicine has. When used inappropriately they can cause much harm. The estimated annual national costs of these preventable adverse drugs events in the hospital and outpatient arena approaches $100 billion.
Nationally, preventing Central Line-Associated Blood Stream Infections (CLABSI) is a major patient safety priority. In total, 100,000 neighbors, friends and family members die because of healthcare acquired infections (HAI) each year. Researchers have estimated the costs of blood stream infections alone to be $9 billion annually.
Despite this emphasis and national organizations agreeing on the scope of the problems and evidence-based tools to eliminate infections, infections remain a vexing problem that have not been solved.
The Blue Cross and Blue Shield Association suggests starting with infections related to blood stream infections, which are associated with 31,000 deaths each year. Evidence-based guidelines and checklists exist to help address this problem.
Improving Surgical Safety
With 234 million major surgical procedures occurring worldwide annually, surgical safety is a public health issue. Tens of thousands of deaths are caused by surgical errors each year. Surgery results in complications for 3 – 17 percent of all patients, and half of all serious adverse events occur to surgical patients. Adverse events include the following:
- Performance of the wrong operation, operating on misidentified patients
- Operating on the wrong body part
- Foreign objects retained after surgery
- Respiratory failure
- Sepsis, pulmonary embolism
- Wound dehiscence
- Surgical site infections (the most common complication)
Blue Cross and Blue Shield of Montana has adopted standards regarding Preventable Adverse Events (PAEs) and will not reimburse acute care hospital charges for services related to a PAE. To view our PAE policy, use the Plan Documents Viewer application in our BCBSMT-branded Payer Spaces section via Availity® Essentials.
In addition to the toolkit, the Blue Surgical Safety Checklist was designed to proactively enforce the importance of patient safety. It was designed by the World Health Organization (WHO) and consists of 19 steps designed to improve communication and consistency of care within surgical teams and reduce avoidable complications.
Blue Surgical Safety Checklist
For hospitals that test the checklist and would like to be recognized on the WHO website, register at WHO.
Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSMT. BCBSMT makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer.