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Capital BlueCross Expands Hospital Partnerships to Improve Patient Care in Central Pennsylvania and Lehigh Valley

Sacred Heart, Summit Health, WellSpan Health join health plan’s QualityFirst initiative

250,000 customers now served by health care models focusing on care quality, not quantity

HARRISBURG, PA. (April 26, 2016) – Capital BlueCross today announced that three health systems have joined the company’s innovative QualityFirst Medical Neighborhood℠ program, a health care model that emphasizes the quality of care provided to patients, rather than the quantity of care. The three health systems are Sacred Heart, Summit Health, and WellSpan Health.

“Together with our hospital partners, Capital BlueCross is helping to make sure that quality of patient care is at the center of the health care system,” said Dr. Jennifer Chambers, senior vice president and chief medical officer at Capital BlueCross. “Not quantity of medical procedures or quantity of office visits, but quality – meaning the best care, with the best outcomes, with the best possible patient satisfaction. By expanding the number of hospitals that are joining us in this endeavor, we are improving care for tens of thousands more people throughout our service area.”

Capital BlueCross’ QualityFirst Medical Neighborhood℠ program was launched in 2014 in Adams and York counties. The program is one of several Capital BlueCross initiatives focused on improving health outcomes by shifting from the traditional fee-for-service model to a performance-based model.

The Medical Neighborhood program incentivizes greater teamwork among health care providers to coordinate patient care; saves money for patients by reducing the administration of procedures that may not be medically necessary; and measures the outcome of care and patient satisfaction using industry-standard evaluation tools.

A key focus of the program is to identify patients who have, or are at risk of, chronic or complex medical conditions. By proactively engaging these patients, health care providers and care coordinators can ensure that treatment and support is provided to help them manage their condition and prevent further complications.

“Sacred Heart Healthcare System is pleased to be a part of the Capital BlueCross Medical Neighborhood Program, where the goal is seamless, high-quality patient-centered care,” said John Nespoli, president and CEO of Sacred Heart HealthCare System. “Patient-centered care is an important philosophy at Sacred Heart Hospital and our multispecialty physician practices.  When our two organizations work together to provide better quality care and improved patient health, it certainly is positive for everyone.”

Dr. Frank Mozdy, vice president and chief medical officer of Summit Physician Services, said, “The QualityFirst Medical Neighborhood program aligns with the Summit Physician Services mission of providing patient-centered, quality care that is affordable and accessible close to home. We are happy to participate in a program that highlights the importance of providing more value to the patients we serve.”

“WellSpan is passionate about coordinated care and transforming health through Patient Centered Medical Homes and Neighborhood,” said Karen E. Jones, M.D., senior vice president, WellSpan Health, and president, WellSpan Medical Group. “Our primary care and specialty care physicians and care teams work together with Patient Partners to improve quality, communication, and care.  It makes sense to align our work with other organizations that are committed to these same goals.”

Capital BlueCross’ patient-focused provider relationships include approximately 256,000 members and 2,200 physicians throughout its service area.

About Capital BlueCross

Capital BlueCross, headquartered in Harrisburg, Pa., is the leading health solutions and insurance company in central Pennsylvania and the Lehigh Valley. A partner in the community’s health for more than 75 years, Capital BlueCross offers health insurance products, services and technology solutions that provide peace of mind to consumers and promote health and wellness for our customers.

More than a health insurer, the company delivers innovative solutions through a family of diversified businesses that is creating a healthier future and lowering health care costs. Among these solutions are patient-focused care models, leading-edge data analytics, and digital health technologies. Additionally, Capital BlueCross is growing a network of Capital Blue stores that provide in-person service and inspiration to help people reach their health goals. Capital BlueCross is an independent licensee of the BlueCross BlueShield Association.