II

BlueCross BlueShield of Tennessee

Change:

BCBST made the following changes to encourage providers to incorporate standard 

ized developmental screening into preventive care visits for children, age six to 36

months:

Providers were reminded about fee for service reimbursement for standardized

developmental screening (CPT 96110) separate from and in addition to preventive

visit reimbursement.

Resource packets were left at each PCP office following personal in service training.

Results:

At the end of the pilot phase the percent of high leverage PCPs with greater than 50

percent developmental screening rate increased from 0 percent to 43.5 percent.

Increases in the preventive visit and screening rates can be attributed to the educa 

tion, training, and RCNA physician outreach efforts.

Overall Accomplishments:

Baseline data from May 2002 to April 2003 showed an 8.9 percent preventive visit rate

with concurrent developmental screening (528 of 5,934).  One hundred percent of

high leverage provider offices

Figure 9: Preventive Visits with Concurrent Developmental

received an outreach visit by

Screening

September 2003.  The next quar 

t

ter (July 2003 through October

18.0%

n

2003) during and immediately fol 

rre

g

16.0%

cu

in

15.8%

lowing the outreach intervention,

n

n

14.0%

o

e

this rate increased to 15.8 percent

 C

cre

12.0%

ith

(414 of 2,626).  This 6.9 percent 

10.0%

tal Sn

age point increase in the preven 

e

8.0%

isits W

8.9%

m

tive visit rate with concurrent

 V

p

6.0%

lo

screening observed in the pilot

tive

ve

4.0%

n

e

project phase, can be attributed

ve

D

2.0%

re

to the successful outreach effort

P

0.0%

by the RCNAs and to the out 

May 2002  

July 2003  

reached providers who were will 

April 2003

Oct. 2003

ing to adopt change to their pre 

ventive visit methods.

In addition to the high leverage providers, nine additional providers who were in the

same offices as the high leverage providers, as well as those who had offices in the

county or surrounding area, also received provider training on standardized screening

when available.

BCBST continued to monitor the compliance of the 34 pilot project providers, as well

as the additional nine providers (43 total providers) who received a training visit, by an

RCNA during calendar year 2004.  BCBST compliance monitoring between December

2003 and May 2004 showed that 58 percent of these providers (25 of 43) visited by

BCBST experienced an increase in their preventive visit rate.  Both the number of pre 

55