$125 MILLION IN SAVINGS, QUALITY OF CARE IMPROVEMENTS IN THE PROGRAM’S LAST 3 YEARS
For more information contact:
Kelly Cannon
Kelly.Cannon@BlueKC.com
O: (816) 395-3711
KANSAS CITY, MO. (October 10, 2024) — Blue Cross and Blue Shield of Kansas City (Blue KC) is proud to announce that its groundbreaking Primary Care First (PCF) program improved quality of care for patients and saved more than $50 million in healthcare costs for members attributed to the program’s participating providers in 2023, helping curtail the impact of medical cost inflation for members and small and large businesses. The Blue KC PCF program, which was the first of its kind locally when it was established in 2010, has achieved total savings of $125 million in the last three years.
Blue KC’s PCF is recognized as one of the most rapid and comprehensive shifts to patient-focused care in the nation by any health plan. Participating doctors, providers and hospitals and Blue KC are jointly accountable for meeting quality and cost measures. This approach modernizes healthcare by rewarding quality of care and results in fewer unnecessary hospital admissions and more preventative care. Payments to hospitals and doctors are based on improved delivery of care rather than the number of procedures or tests performed. This program works with community providers to build a system where high-quality care is affordable and accessible for all members in Blue KC’s 32-county service area in Greater Kansas City and Northwest Missouri.
“From all of us at Blue KC, we sincerely thank all the Blue KC PCF participants for partnering with our patient-focused care programs that are transforming healthcare and improving people’s health in our community,” said Erin Stucky, Blue KC President and CEO.
“Since launching our Medical Home program in 2010, Blue KC has been proud to work with primary care practices across the Kansas City region, and it’s amazing to see how the program continues to help improve the quality of care for their patients while lowering their healthcare costs,” said Dr. Greg Sweat, Blue KC Senior Vice President and Chief Health Officer.
“Here at Sunflower Medical Group, we have worked closely with Blue KC for many years now, partnering with them on many quality improvement and healthcare transformation efforts,” said Dr. Yvette Guislain Crabtree, Director of Clinical Quality, Sunflower Medical Group. “Our group, along with our many primary care patients, have benefited greatly from this partnership. We look forward to continuing to work with them in the future.”
Doctors and hospitals participating in Blue KC’s PCF program met their performance goals by delivering high-quality, cost-effective care for the nearly 350,000 members they served in 2023. Members who saw Blue KC PCF providers benefited from enhanced quality of care, including:
- More consistent screening and treatment of diabetes and high blood pressure.
- 80% demonstrated control of their diabetes, compared with 55% of members who received services from providers who do not participate in Blue KC PCF.
- 72% demonstrated control of their high blood pressure, compared with 40% of members who received services from providers who do not participate in Blue KC PCF.
- Higher rates of preventative care and cancer screenings.
- 73% were screened for colorectal cancer, compared with 44% of members who received services from providers who do not participate in Blue KC PCF.
- More children connecting to their PCP or pediatrician for annual well-child visits.
- 68% of children and adolescents had their annual well-child visits compared with 31% of children and adolescents who received services from providers who do not participate in Blue KC PCF.
Blue KC PCF Participation
Blue KC PCF doctors, providers and hospitals are advancing and participating in a pathway to value agreements – accountable financially for meeting cost and quality standards.
- Blue KC is the largest not-for-profit health insurer in Missouri and the only not-for-profit commercial health insurer in Kansas City with coverage options for individuals of all ages, and for businesses of all sizes. The Blue KC PCF program includes doctors, providers and hospitals serving members in our 32-county service area in Greater Kansas City and Northwest Missouri, helping provide critical access to primary care.
- Partnerships with more than 190 primary care practices in our service area. That includes 220 locations with more than 1,800 primary care providers.
- Health systems and physicians currently in the Blue KC PCF program account for more than 60% of Blue KC’s total medical expense, excluding prescription drug costs.
About Blue Cross and Blue Shield of Kansas City
Blue Cross and Blue Shield of Kansas City, the largest not-for-profit health insurer in Missouri and the only not-for-profit commercial health insurer in Kansas City, has been part of the Kansas City community since 1938. Blue Cross and Blue Shield of Kansas City provides health coverage services to more than one million residents in the greater Kansas City area, including Johnson and Wyandotte counties in Kansas and 30 counties in Northwest Missouri. Our mission: to provide affordable access to healthcare and to improve the health of our members. Blue Cross and Blue Shield of Kansas City is an independent licensee of the Blue Cross and Blue Shield Association. For more information on the company, visit its website at BlueKC.com.
