Quality Improvement Efforts at BCBSMT

Jul. 02, 2015

BCBSMT is in the final stages of achieving our URAC accreditation. As part of that effort, we have developed some clinically-focused quality improvement projects in addition to our standard quality measures. We have always strived for quality and promoted healthy living. But we need your help. We know that working with our provider community is the key to success.

Our focus includes:

  • Increasing eye exam rates for individuals with Diabetes
  • Improving childhood immunization rates
  • Improving Colorectal Cancer screening rates
  • Increasing wellness program participation

Eye Exams

The BCBSMT rate for eye screening for diabetic retinal disease is good. Our Montana plan members rank above the national average of 46.9 percent. However, is having half of our population in compliance good enough? Why not strive for 100 percent. So, next time your patient with Diabetes comes in for an appointment, check with them to ensure:

  • They have had a recent retinal eye exam by an eye care professional
  • They are monitoring/managing their blood sugars
  • They are keeping their blood pressure under control
  • If they smoke, talk to them about ways to kick the habit

Childhood Immunizations

In regards to childhood immunization rates, Montana ranks below the national average of 38.7 percent. In 2013, our state had the highest incidence of whooping cough in the nation. Montana needs to get on track and help our children get the necessary care they need. Take every opportunity/encounter to provide and promote vaccinations. To assist in these efforts, BCBSMT has partnered with the community to help grow and maintain vaccine rates through its Care Van. The Care Van is a mobile unit that assists in providing vaccines at no cost or low cost to all Montanans. If your area could benefit from an immunization clinic, contact our Care Van administrator by email at bryan_haines@bcbsmt.com or give him a call at 406-437-6198.

Colorectal Cancer Screening

For the last several years, MT has ranked among the lowest in the nation for colorectal cancer screening. Colon cancer is the second leading cancer killer of men and women. In an effort to stop this deadly disease, BCBSMT has teamed up with the American Cancer Society and the Department of Public Health and Human Services Cancer Control Division. Together, we are working towards the nationwide goal of 80 percent screened by 2018. You can help by promoting screening in the appropriate population. For patients age 50-75 or at high risk, evaluate, recommend, schedule and/or order the necessary testing:

  • Stool testing (guaiac fecal occult blood test – FOBT or fecal immunochemical test – FIT) yearly
  • Flexible sigmoidoscopy every 5 years
  • Or colonoscopy every 10 years

As indicated above, we all have a long road ahead. Recommendations and coverage for routine eye exams, immunizations, and colorectal cancer screenings are just a few of the ways we can help Montanans live healthier lives. We all need to do our part to promote healthy living and lifestyles through a variety of ways. As health care providers, you are the primary resource and link to our members. Make preventive care a priority. We owe it to ourselves and our communities.

View 2015 news and updates