After only one year, a pilot program designed to measure patient quality of care shows significant clinical outcomes and health care cost reductions. The Wellmark Blue Cross and Blue Shield 2008 pilot was a quality improvement program for Iowa and South Dakota physical medicine providers. A total of 238 chiropractors, physical therapists, and occupational therapists participated in the pilot, submitting information on the care provided to 5,500 Wellmark members with musculoskeletal disorders.
Data from participating clinicians show that 89 percent of the Wellmark members treated in the pilot reported a greater than 30 percent improvement in 30 days. In addition, Wellmark claims data for members who received care from chiropractors or physical therapists was compared with data for a member population with similar demographics (including health) who did not receive such services. The comparison showed that those who received chiropractic or physical therapy care were less likely to have surgery and experienced lower total health care costs.
Commenting on the value of the program's data collection and reporting, Dr. Shayan Sheybani, clinics operations administrator at Palmer College of Chiropractic, said the following:
"The faculty, staff, and interns of the Palmer Clinics were able to objectively and consistently gather valuable information for services provided for our Wellmark patients that support the College's commitment to providing quality patient care. Overall, we have a positive impression of this program, and we are planning to continue our participation during the 2009 fiscal year. Continued participation in Wellmark's pilot satisfies our desire to contribute to new knowledge, continual improvements, and the development of quality-focused patient care."
Pamela A. Duffy, PT, PhD, OCS, Wellmark's physical medicine director, believes the results are reflective of the participants' commitment and dedication to providing quality care. "Participants in our first pilot on quality are dedicated to pursuing professional development, improving quality health care, and helping their patients live the most productive and pain-free lives possible. Wellmark is very pleased with the clinical outcomes demonstrated by these practitioners, and will continue working with providers to design programs that help evaluate the value of physical medicine services for members."
Triad Healthcare will continue to administer the 2009 program for Wellmark, which is open to participating Wellmark medical and osteopathic physicians, podiatrists, chiropractors, physical therapists, and occupational therapists in Iowa and South Dakota. To obtain additional information about the 2009 Physical Medicine Pilot on Quality, contact Wellmark at 800-799-0199, option 1.
Wellmark, Inc., does business as Wellmark Blue Cross and Blue Shield of Iowa. Wellmark and its subsidiaries and affiliated companies, including Wellmark Blue Cross and Blue Shield of South Dakota and Wellmark Health Plan of Iowa, Inc., insure or pay health benefit claims for more than 2 million members in Iowa and South Dakota. Wellmark Blue Cross and Blue Shield of Iowa, Wellmark Blue Cross and Blue Shield of South Dakota, and Wellmark Health Plan of Iowa, Inc. are independent licensees of the Blue Cross and Blue Shield Association.
Source: Wellmark
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