II

BlueCross BlueShield of Tennessee

Measure:

# of high leverage providers receiving educational in service

# of high leverage providers

Change:

BCBST made the following changes to facilitate training and outreach to the identified

high leverage provider sites: 

Distributed stratification report to nurse outreach worker.

Modified PCP contact database to include standardized developmental screening

field.

Developed training packets for the nurse outreach worker to use when visiting PCP

offices.  The training covered background on the PEDS screening tool, how and

when to administer it, and the reimbursement process.  

The nurse outreach worker contacted each PCP office by phone and conducted at

least one in service at each site.

Results:

All (100 percent) of the 34 high leverage providers and their office staffs received an

educational in service. Providers and office staff learned how to obtain the PEDS test

and additional information was included to assist with referrals for problems identified

through the PEDS test, if necessary. The training packet included contact information

for the Tennessee Early Intervention System, which offers a directory of programs,

resources, and professionals for infants and toddlers with disabilities and their families. 

INTERVENTION 

BCBST set a goal to ensure that all identified high leverage providers perform a stan 

dardized developmental screening within at least half of their pediatric preventive care

visits for children, age six  to 36 months.

Aim:

To ensure that 100 percent of high leverage PCPs perform a standardized develop 

mental screening as part of preventive visit at least 50 percent of the time.

Measure:

# of high leverage PCPs with greater than 50 percent rate for standardized 

developmental screening

# of high leverage PCPs

54