Blue Cross and Blue Shield of Vermont Recognized for Quality

SEPTEMBER 16, 2021

Berlin, Vermont —The National Committee for Quality Assurance (NCQA) announced that Blue Cross and Blue Shield of Vermont (Blue Cross) was rated among the highest commercial health insurance carrier scores in Vermont. Blue Cross was rated 4.5 out of 5 in NCQA’s Commercial Health Plan Ratings 2021.  

“At a time when Vermonters are facing incredible pressures, we have a keen focus on care management to ensure that our members have the support they need,” says Dr. Joshua Plavin, Vice President and Chief Medical Officer at Blue Cross and a practicing physician of Pediatric Internal Medicine. “We are particularly proud of our scores for supporting our members’ mental health.”

A clear emphasis of the State of Vermont is addressing gaps in care for mental health. Blue Cross and Blue Shield of Vermont received NCQA scores of 5 out of 5 for: members adhering to depression medication for 6 months; follow-up after hospitalization for mental illness; follow-up after ED for mental illness; follow-up after emergency department visits for alcohol and other drug abuse or dependence; and engagement in treatment for alcohol or drug misuse. 

Blue Cross has focused on supporting these services through ensuring access to telehealth, both by encouraging long-standing provider-patient relationships and working closely with our provider network to connect members with new care providers. An innovative solution to care is providing bridges for our patients through services like Alpine Telehealth, which is a Vermont-based psychiatrist provider group. 

The non-profit, Vermont based health plan continues to work to support mental health and physical health integration in the health care system as a whole. Despite access challenges across the state, Blue Cross is keenly focused on this population to ensure patient needs are being met.

“Another area of focus for us is on maintaining and improving child and adolescent vaccine rates despite the challenges that the pandemic presented,” says Dr. Plavin. 

While the pandemic slowed in-person visits for a time, Blue Cross and provider partners are encouraging families to make their well child and vaccine appointments.

NCQA ratings are based on three types of quality measures. The overall rating is based on performance on dozens of measures of care and is calculated on a 0–5 scale in half points (5 is highest). Performance includes three subcategories:

Patient Experience: Patient-reported experience of care, including experience with doctors, services and customer service.
Rates for Clinical Measures: The proportion of eligible members who received preventive services (prevention measures) and the proportion of eligible members who received recommended care for certain conditions (treatment measures).
NCQA Health Plan Accreditation
Blue Cross and Blue Shield of Vermont is Vermont’s only local, not-for-profit health plan. For over 30 years, the company has been enhancing the health and well-being of the Vermonters by offering innovative plans to individuals, seniors and businesses. Our employees are dedicated to developing new ways to support high quality care and programs and events that promote health and wellness. Blue Cross and Blue Shield of Vermont is an independent licensee of the Blue Cross and Blue Shield Association.

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