2016 Winner Profile

BlueCross BlueShield of Tennessee

Project Description:
BlueCross BlueShield of Tennessee implemented the Provider Performance Module (PPM) in 2014. Challenged with identifying non-compliant members and closing gaps in care, while enhancing their associate's ability to access and analyze data about their members, PPM incorporates several technology solutions that interactively display relevant information from the data warehouse to the providers. The Web-based interactive dashboard enables BCBS of Tennessee network providers to view important quality metrics, member gaps in care, and track incentive opportunities while offering providers with a self-report of any care gaps. This has improved the collection of clinical data while increasing the health care providers over quality rating of 3.5 STARS in 2015 to 4 STARS in 2016 equating to approximately $20 million in additional revenue.
Business Functions:
Customer Service or Support, Research & Development
Business Goal:
Operational Impact
Sherri Zink, SVP & CDEO
JD Hickey, CEO
Chattanooga, Tenn.
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