Providers Quality

Implementing a broad quality focus includes working side-by-side with the providers who serve our members. We hope our Health Campaigns help with guaranteeing that partnership.

BlueCare Tennessee Health Campaigns include:

  • Postcards
  • Community Events
  • Health and wellness postings on Facebookat
  • Posters and brochures for provider offices such as these shown below:

Each flier addresses a specific quality measure and gives you actionable information to help improve quality outcomes.

Best Practices Current Initiatives:

Best practices are developed and used to maintain quality in order to uphold standard business practices. Below are several of the BlueCare Tennessee Best Practices.

  • Million Hearts Campaign

    Million HeartsThe Million Hearts® initiative focuses, coordinates, and enhances cardiovascular disease prevention activities across the public and private sectors in an unprecedented effort to prevent 1 million heart attacks and strokes by 2017. Million Hearts will scale-up proven clinical and community strategies to prevent heart disease and stroke across the nation, while helping Americans see that improving the health system can save lives. Click the image to learn more about this campaign:

    As part of its commitment to help Million Hearts reach its goal, BlueCare Tennessee supported the Measure Up/Pressure Down® National Day of Action: “Roll up Your Sleeves!” Campaign. BlueCare Tennessee continues to distribute member education materials at office and community events.

    BlueCare Tennessee is also listed as a participant on the Measure Up/Pressure Down website. Information for health care professionals can be found at the following link:

  • Pediatric Asthma

    The Pediatric Asthma program was developed in 2010 to improve asthma care and member self-management of asthma. For information on this initiative refer to Pediatric Asthma Initiative (page 117 of the Medicaid Health Plans of America (MHPA) 2012-2013 Best Practices Compendium)

  • Diabetes Gaps In Care

    An individual’s care is often fragmented and treatment compliance is difficult to evaluate; therefore, we did partner with providers to give them a comprehensive member picture and to better assist them when treating diabetic patients. For information on this initiative refer to Diabetes Gaps-In-Care

  • Breast Cancer Screenings

    After determining the targeted population, a BlueCare East Breast Cancer Screening intervention was implemented in December of 2012, targeting members with a gap in breast cancer screening in the east counties of Tennessee, dedicating five Member Education staff to this project. While outreach calls for Breast Cancer Screening are regularly made by Member Education staff, it is not part of the usual and customary process to dedicate staff to this task.
    For information on this initiative, refer to Breast Cancer Initiative

  • Pay for Gaps (P4G)

    The Pay for Gaps Initiative (P4G) to reimburse providers for closing gaps began in November 2013 and continues in 2014. The gaps considered with this initiative are:

    • Immunizations for children and adolescents
    • Diabetes
    • Breast cancer screening

  • BEHIP - Behaviorally Effective Healthcare in Pediatrics

    A collaborative training project between BlueCare Tennessee and the Tennessee Chapter of the American Academy of Pediatrics (TNAAP) that aims to educate providers to:

    • Use tools and strategies to screen for, assess, and manage patients with emotional, behavioral, and substance abuse challenges
    • Know and access behavioral health resources
    • Train other primary care providers on these tools and principles
    • For more information, refer to the following link: BEHIP

  • Follow Up After Hospitalization for Mental Illness

    The need to improve follow-up after hospitalization for mental illness was recognized and steps were taken to improve the percentage of discharges for members 6 years of age and older who were hospitalized for treatment of selected mental health disorders who had an outpatient visit, an intensive outpatient encounter or partial hospitalization with a mental health practitioner.

  • Postpartum Depression

    We begin our postpartum intervention on the day of discharge to ensure our members receive needed care before leaving the hospital. Since the intervention began, more than 6,173 women have been screened for postpartum depression and referred for behavioral health services when indicated.