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The clinical summaries are part of HCSC's Blue Care Connection program,which is designed to encourage the pursuit of evidence-based care so thatmembers can improve their health and avoid unnecessary medical costs.Summaries are available now for members in Illinois, New Mexico and Texas, andwill be available this fall for members in Oklahoma.
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"The value of these electronically available clinical summaries for ourmembers is not only that they provide a concise history of the medicalservices that we have reimbursed physicians and hospitals for on a member'sbehalf, but that members will be able to see for themselves potentialopportunities for intervention and prevention that they can discuss with theirdoctors in hopes of leading healthier, more productive lives," said WilliamGerardi, M.D., clinical advisor for Blue Care Connection.
HCSC developed Blue Care Connection as a means of addressing the problemsof increasing medical costs and uneven medical quality. The collaborative caresystem is designed to link members, health care providers and HCSC's caremanagement clinical staff. The system enables medically recognized clinicalrules and protocols to be applied to member health data from claims, healthcare provider records and self-reported member information. Based on theavailable information, best-practice treatment opportunities can then beidentified and pursued to optimize member health and minimize member healthcare costs. Those opportunities can be updated whenever additional informationis added.
HCSC hopes Blue Care Connection will serve as a model for increasingconsumer control over personal health and out-of-pocket health care costs,reducing medically unnecessary spending so that health insurance can becomemore affordable, and recognizing best outcomes to encourage optimum carethroughout the health care system.
Health Care Service Corporation, a Mutual Legal Reserve Company, is thelargest customer-owned health insurer in the United States and the fourthlargest health insurer in the country overall, with 11.5 million members inits Blue Cross and Blue Shield plans in Illinois, New Mexico, Oklahoma andTexas. HCSC has a rating of AA- (Very Strong) from Standard and Poor's, Aa3(Excellent) from Moody's and A+ (Superior) from A.M. Best Co. HCSC is anindependent licensee of the Blue Cross and Blue Shield Association.
SOURCE Health Care Service Corporation
