The new health care reform laws and a struggling economy present some unique challenges for all of us. Nonetheless, the uncertainty we are facing in Montana and throughout America presents us with an opportunity to improve our health care system and the manner in which we all access quality medical care.

At Blue Cross and Blue Shield of Montana, we are doing all we can to partner with Montanans to provide affordable, high-quality health insurance and wellness solutions. To do so, we are collaborating with our members, medical providers, hospital administrators and leaders in government to improve our existing health care system, with a focus on continuing to reduce the costs of health care while retaining and improving upon the quality of care people receive. We are making good progress.

First, BCBSMT is partnering with medical providers to improve the way health care is delivered. We are creating “patient-centered medical home” programs throughout the state of Montana, an innovative new approach that rewards medical providers for proactive communication with their patients as they work to prevent disease and more effectively manage chronic conditions such as diabetes. Throughout the United States, the introduction of patient-centered medical homes has resulted in healthier, more satisfied patients; in medical providers who are more engaged with their patients; and in overall reduction of health care costs.

Second, BCBSMT is making significant advances in easing access to affordable prescription therapies. It is no secret that innovative new biotherapeutic drugs can cost tens of thousands of dollars every year. Those medications, along with increasing costs of more standard pharmaceuticals, are contributing significantly to the overall increase in the costs of health care. To help reduce those costs — without compromising the health and well-being of our members — BCBSMT has launched EfficientRx, a pharmaceutical formulary program that helps patients access the medications they need while achieving savings through negotiated discounts and reasonable copayment tiers that reduce overall costs. We are finding that BCBSMT members favor EfficientRx because the service it provides is efficient and affordable. Further, small and large business employers alike who choose to use the EfficientRx program are benefiting greatly as the program continues to help control the costs of their health care plans.

Finally, we are helping to drive down costs of health care through promotion of wellness and personal responsibility for health. In partnership with employers and our members, we have created several innovative wellness initiatives. For example, we are introducing outcomes-based wellness programs to our customers, initiatives that reward our members for participation in preventive care, for refusing tobacco use and for maintaining a healthy body mass index score. By participating in our new wellness programs, BCBSMT members whose employers are partnered with us on this initiative can actually save money through their own commitment to wellness.

The innovations and strategies BCBSMT is bringing our customers, employers, employees, providers, and to all Montanans are positioning us all to continue to thrive during these uncertain times. With our 70-plus-year heritage of serving Montanans and our recent efforts to significantly reduce our company’s administrative costs, I have great confidence that our company and Montanans are poised to help Montana make the most of the many opportunities we have to improve the health care system in the Big Sky State.

Mike Frank is president and CEO of Blue Cross and Blue Shield of Montana, website


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