At Blue Cross and Blue Shield of New Mexico (BCBSNM), we never stand still or say that’s good enough. Using continuous quality improvement efforts, we examine member health issues. We decide what to focus on based on what’s important to our members.
We use our experience and try new methods that data suggest will help us help our members. Then we measure how we did, and we keep going. Or as the quality improvement industry defines the cycle: measure, analyze, improve, repeat.
Health plans like BCBSNM work with groups of experts to measure how we’re doing and make continuous quality improvement for members. For example, BCBSNM works with an organization called the National Committee for Quality Assurance® (NCQA). NCQA rates health plans based on three measures of quality: clinical data, consumer satisfaction data and quality process assessment.
How We Choose Quality Improvement Areas
BCBSNM follows guidelines from NCQA to measure what health issues our members struggle with the most. For example, in 2017, we chose several preventive disease management topics. For prevention, we focused on flu shots, childhood immunization, and colorectal cancer and breast cancer screenings. For disease management, we looked at coronary artery disease and diabetes.
How We May Reach Out to You
We reach out to members with educational information about these topics in as efficient a way as possible.
For many members, we send emails with facts and tips members can use to manage their health. For members without email addresses, we send direct mail. We also have detailed online educational content that includes blogs, videos and links to external resources.
When we send you information about a disease like coronary artery disease or diabetes, we choose the topic based on your claims data. But protecting your personal health care information is important to us. So whether we use email or mail, the outside of any communication only has general information. Only you will see the specific information about health conditions inside the communication.
We make every effort to get the word out to members who can use the information. Our goal is to make sure members know their options and how to access the preventive services and help they need to maintain their best possible health.
HEDIS is a registered trademark of NCQA.