SOURCE: Information Builders

Information Builders

December 21, 2016 09:00 ET

BlueCross BlueShield of Tennessee Awarded for Superior Patient Care

Health Plan Uses Data Management and Analytic Technology to Close Care Gaps, Leading to a Boost in NCQA Star Ratings

NEW YORK, NY--(Marketwired - Dec 21, 2016) - Information Builders, a leader in business intelligence (BI) and analytics, information integrity, and integration solutions, today announced that its customer, BlueCross BlueShield of Tennessee (BCBST), has received several prestigious awards for outstanding use of analytic and data management technology. In addition, BCBST's systematic efforts to use this technology to close patient care gaps have allowed the health plan to boost its Star ratings, leading to a healthier patient population and more favorable reimbursements from the U.S. Centers for Medicare and Medicaid Services (CMS).

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IDG Enterprise named BCBST a 2017 Digital Edge 50 Award winner for the Clinical Data Exchange platform, which BCBST analysts use to identify health plan members who are not getting the care they need based on their age and identified health conditions. An associated analytic portal helps medical providers who contract with BCBST ensure that their patients receive the right tests, screenings, and evaluations to treat or prevent diabetes, cancer, heart disease, and other chronic conditions.

In addition, the BlueCross BlueShield Association honored BCBST with several People's Choice Awards at its recent Information Management Symposium. The association acknowledged the Clinical Data Exchange for its ability to deliver an excellent source of clean, reliable data about BCBST members with open care gaps.

According to Gregory Dorman, senior vice president and general manager of iWay products at Information Builders, "The Clinical Data Exchange uses the Omni-Patient™ application to intake data from multiple sources, match the data to defined subjects, master and maintain the data, and make it available for analysis through downstream processes. BCBST has established a solid foundation for quality-based contracting, more precise outreach and intervention, population health analytics, and provider/payer collaboration. Medical practices that contract with BCBST can more easily coordinate needed screenings and services for patients, as well as gain valuable information for accurate reporting."

The National Committee on Quality Assurance (NCQA), which compiles annual performance ratings on more than 1,000 health plans, recently announced a boost in BCBST's Star ratings for its success closing patient care gaps and helping members obtain recommended care. The NCQA uses Healthcare Effectiveness Data and Information Set (HEDIS) metrics to determine the effectiveness of BCBST's healthcare delivery model. BCBST's medical management resources now have the most complete and clinically relevant information to help members achieve optimal health outcomes.

"As the health insurance market shifts toward value-based payment models, the Clinical Data Exchange addresses the growing need for providers to share robust, timely, and accurate clinical information with health plans," said Gerald Cohen, president and CEO at Information Builders. "CMS depends on NCQA ratings to determine how health plans perform in several categories, including quality of care and customer service. BCBST is using technology to boost its ratings, improve reimbursement levels, and offer better services to Tennessee citizens."

About BlueCross BlueShield of Tennessee
BlueCross BlueShield of Tennessee's mission is to provide peace of mind through better health. Founded in 1945, the Chattanooga-based company is focused on serving more than 3.4 million members in Tennessee and across the country. BlueCross BlueShield of Tennessee Inc. is an independent licensee of the BlueCross BlueShield Association. For more information, visit the company's website at bcbst.com.

About Information Builders
Information Builders provides solutions for business intelligence (BI), analytics, data integration, and data quality that help drive performance improvements, innovation, and value. Through one set of powerful products, we enable organizations to serve everyone -- analysts, non-technical users, even partners, customers, and citizens -- with better data and analytics. Our dedication to customer success is unmatched with thousands of organizations relying on us as their trusted partner. Founded in 1975, Information Builders is headquartered in New York, NY, with global offices, and remains one of the largest independent, privately held companies in the industry. Visit us at informationbuilders.com, follow us on Twitter at @infobldrs, like us on Facebook, and visit our LinkedIn page.

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