BlueCross BlueShield of Tennessee

BCBST provided training on the PEDS Test for 34 provider sites through their

Regional Clinical Network Analyst (registered nurse/outreach worker).  The out 

reach worker had direct contact with all the targeted provider sites through tele 

phonic outreach and at least one visit to each office.  Training packets were devel 

oped for the outreach worker to use when visiting PCPs and training office staff.

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The training focused on how and when to administer the PEDS test as well as how

to navigate the reimbursement process.  To reinforce the training, an article was

placed in the provider newsletter.

Lovelace Community Health Plan

Lovelace aimed to improve screening and referral rates by training providers about

standardized screening and the Family Infant Toddler (FIT)

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referral process.

Lovelace oriented providers to the ASQ screener by visiting selected pilot site prac 

tices and reviewing the ASQ with providers. Lovelace staff learned that although

all of their providers had heard of the ASQ, and understood the importance of

timely and quality well visits, none of the providers had seen the questionnaire and

some thought that it had to be administered at every EPSDT visit.  Providers

responded positively to the ASQ training, recognizing that ASQ offers an easy tool

that could be used throughout the office. Lovelace also sought to educate providers

on the FIT Program referral process.  Many providers were making referrals for ther 

apies that were non covered services and many providers did not know how to

make a referral to the FIT program.  Lovelace developed a list of local FIT providers

and covered services for each pilot site.  Through provider outreach, the health plan

was able to educate providers on how to incorporate standardized screening into

well child care and how to appropriately navigate the referral process.

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CommunityCARE

CommunityCARE set a goal to increase provider knowledge of standardized devel 

opmental screening tools.  CommunityCARE staff was trained on Bright Futures

Guidelines (see Bright Futures, page 36) and added the PEDS and ASQ screeners to

the tools available to providers. It was originally envisioned that increasing the

number of available tools would increase flexibility for providers and thus improve

screening rates.  CommunityCARE reports that increasing the number of screening

tools did not yield an increase in referral rates in most cases.  They learned that

increasing the number of accepted tools requires time intensive training and aware 

ness building around the pros and cons of each tool.

CommunityCARE also developed and distributed a Provider Training Guide to help

providers direct members to appropriate services. The guide includes community

resources, best practices for data collection, and anticipatory guidance materials.

Among the community resources included were:  Friends and Family,  a program

providing non emergency transportation for Medicaid recipients;  Nurse Family

Partnership,  nurse home visiting program for first time, low income mothers and

their families; and the  Early Steps Program,  Louisiana's early intervention program.  

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BlueCross BlueShield's Provider Training Packet are available in the toolkit online resources at www.chcs.org. 

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The Family Infant Toddler Program is New Mexico's early intervention program.

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See the case study on page 57 for more information on Lovelace's pilot.

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