Programs

Prevention initiatives

Physician recognition: Blue Care Network recognizes physicians for outstanding clinical and service performance resulting in more of our members receiving immunizations and health screenings.

Preventive benefits and our Guidelines to Good Health (for our commercial members): All of our members are covered for important health screenings and immunizations (normal copayments apply). At least once per year all members receive our Guidelines to Good Health. Members with access to the Internet can view our Guidelines to Good Health on our Web site.

Reminder cards: We periodically mail reminders to our members to encourage them to stay current on child and adolescent immunizations, flu shots and pneumonia vaccines. We also send reminders for cholesterol, colorectal, breast and cervical cancer screenings, as well as to schedule annual exams.

Blue365®: Complement your health plan by accessing trusted health and wellness resources, including informative webinars. Blue365 offers you big savings and discounts on weight management programs, gym memberships, family care and healthy travel getaways with many well-known companies.

Living with illness

Management is your key to living with a chronic medical condition. We have developed a variety of living with illness programs, in partnership with our primary care physicians, to help you manage your chronic condition(s). These BlueHealthConnection® programs provide the tools you need to achieve the best possible quality of life.

Programs for getting better

At Blue Care Network of Michigan, we encourage our members to seek their highest possible level of health and fitness and support them through their recovery when they need us.

Behavioral health: Our members can contact BCN’s behavioral health care managers at any time — around the clock — for help with behavioral health and substance abuse problems. A referral from the member’s primary care physician is not needed. Our behavioral health care managers evaluate our member’s situation and arrange services.

Case managers: Our nurses are available to educate members and coordinate services for a variety of conditions. Our case managers not only provide a comprehensive and confidential assessment, but also develop a care plan in collaboration with the member and his or her doctor. We have nurse specialists for heart disease, high-risk pregnancies, oncology, transplants and renal management.

Centers of Excellence: We encourage our members to seek care at one of our Centers of Excellence — Michigan hospitals and facilities that satisfy our rigorous guidelines for quality. These Centers of Excellence have consistently demonstrated better outcomes and fewer complications in bariatric surgery, cardiac care and low back pain.

Depression program: When one of our members fills a prescription for antidepression medication, we send information about how to take the medication and a tip sheet on depression. We contact members who fail to fill or refill antidepression medications.

Emergency room intervention: Our nurses call members who use the emergency room frequently to review the reasons for the emergency care and, when it’s appropriate, redirect them to other care settings.

Follow-up after hospital stays: Our nurses review hospital stays and work closely with patients, their family members and physicians when additional care is needed after discharge. Our nurses contact patients after they leave the hospital to make sure they understand their medical condition, their medications and the need to follow-up with their physician.

Partnering with doctors: We provide our physicians with important information to help them care for our members. This includes patient-specific reports, summaries of their medical and pharmaceutical practice patterns, the latest treatment protocols and notices when their patients are hospitalized or seek emergency care.

Pneumonia and flu intervention: We send reminders to our members at greatest risk to encourage them to get the flu and pneumonia vaccines.

Quit the Nic! (for our commerical members): Our free smoking cessation program has a proven track record of helping members give up tobacco for good. Our physicians are leading the charge to encourage our members to stop using tobacco — three-quarters of our smoking members were advised about our program last year by their doctors. Members enrolled in our Quit the Nic! program can have their over-the-counter drugs covered for three months. This coverage is renewable if they re-enroll in the program.

Stroke and heart attack prevention: BCN monitors for anticoagulation medications prescribed following atrial fibrillation. We also contact our members who’ve had heart attacks to inform them of the importance of beta-blocker treatments.

page modified 03/20/2009