II

BlueCross BlueShield of Tennessee

Change:

To maximize the potential of their intervention, BCBST developed a report of high 

leverage PCPs containing individual PCP data as well as data aggregated by number

of preventive visits performed and percent of preventive visits with documented stan 

dardized developmental screen. The report divided providers into four indicator

groups by calculating all four possible volume and opportunity ratios:

High Volume and High Opportunity

High Volume and Low Opportunity

Low Volume and High Opportunity

Low Volume and Low Opportunity

Figure 8: PCP Indicators Based on Preventive Visits

7,000

6,000

5,000

f

isits

r o

 V

4,000

eb

3,000

tive

m

n

u

2,000

N

vere 1,000

P

0

High Leverage =

High Volume and

High Volume and

Low Volume and

Low Volume and

High Opp PCPs

Low Opp PCPs

High Opp PCPs

Low Opp PCPs

PCPs #

34

3

86

1

PCPs %

27.4%

2.4%

69.4%

0.8%

Visits #

6,696

838

1,153

9

Visits %

77.0%

9.6%

13.3%

0.1%

Results:

Through this innovative stratification approach BCBST determined that 34 PCPs per 

formed the majority (77 percent) of preventive visits and also had a preventive visit

standardized developmental screen rate of less than 50 percent.  By targeting out 

reach efforts to these high leverage PCPs, BCBST could maximize the potential of their

intervention activities.  The stratification report allowed the plan to quantitatively track

their progress over time.

OUTREACH 

After identifying the 34 high leverage provider practices, BCBST devised an outreach

strategy to encourage these practices to improve the delivery of standardized devel 

opmental screening within EPSDT appointments.  

Aim:

To conduct provider education in services at 100 percent of the high leverage provider

sites (34).

53