Blue Advantage MSC+ Blue Plus

MSC+ Health Plan Overview Melody Bialke, February 21, 2008

© 2007 Blue Cross and Blue Shield of Minnesota

Overview > Blue Plus Philosophy > Blue Advantage Service Area > Care Coordination > Access to Care > Blue Advantage Member Advantages > Blue Advantage Contact Information

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Blue Plus Philosophy > Serve the whole person – Meet member needs:

addressing medical, social and behavioral health.

> Build globally, act locally – Strive to maintain a

statewide model for care management, customizing it to meet the needs and drawing upon the resources of local communities.

> Accountability through partnership – Enhance the

relationship between Blue Plus and counties with an efficient, high quality care coordination model that builds upon the strengths of both partners.

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Blue Advantage Service Area Blue Advantage MSC+ serves beneficiaries in 46 counties

Blue Plus Blue Advantage MSC/MSC+ Service Area Roseau

Kittson

Lake of the Woods

Marshall Koochiching Pennington

Cook

Red Lake Polk

Norman

Mahnomen

Lake

St. Louis

Beltrami Clearwater

Blue Advantage MSC serves beneficiaries in 6 counties

Itasca CBP

Hubbard Cass

Becker

Clay

Aitkin

Wadena

Pine Todd

Sherburne

Meeker PW

Anoka

Wright

McLeod Carver PW

Redwood

Nicollet

Washington Ramsey

Scott

Sibley Lyon

MSC – 6 counties MSC+ – 46 counties

Isanti Chisago

Hennepin

Lac Qui Chippewa Parle Renville Yellow Medicine PW

Lincoln

Kanabec

Benton Stearns

Kandiyohi

Swift

Mille Lacs

Morrison

Grant Douglas PW PW Stevens Pope PW PW

Big Stone PW

Carlton

Crow Wing

Otter Tail

Wilkin

Traverse PW

Le Sueur

Dakota Rice

Goodhue

Wabasha

Brown Pipestone Murray PW Rock

Nobles

Cottonwood

Watonwan

Jackson

Martin

Blue Earth

Waseca

Faribault

Steele

Freeborn

Dodge

Olmsted

Mower

Winona

Fillmore

Houston

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Blue Advantage Care Coordination Blue Advantage care coordinators > encourage independent living, > coordinate and integrate medical and social services, > encourage care in the least restrictive setting, > honor the care choices and dignity of members, and > are proactive in preventing unnecessary

illness/hospitalizations

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Blue Advantage Care Coordination Model Care Coordination > is provided locally, whenever possible, through county

partnerships

– Served by County of Residence

> builds upon – existing knowledge of available resources – established relationships with potential members, the medical community, and formal and informal networks of support

Blue Plus provides case management support to the local care coordinators 6

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Blue Advantage Care Coordinator Role > Face-to-face health assessment for all members > In concert with member, development of Care Plan and

follow-up

– Facilitation of annual physical – Preventive care monitoring (immunizations & supplements)

> Primary point of contact for member, family, guardians,

& providers

> Coordination with local agency social services, public

health, & financial services

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Access to care > Open access plan - members may see any Blue Plus

network provider for a covered service without a referral.

– Member must identify a Primary Care Clinic that their personal

physician is associated with.

> Largest and most widely distributed provider network in

Minnesota

– 96% of providers statewide, – 100% of nonfederal hospitals,

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Access to care > Dental Network – Delta Dental network, including dental advocate services

> Pharmacy Network – Prescription drugs are available through our nationwide network of

pharmacies.

> Blue Ride Transportation – Medical visits – Rx pick-up

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Blue Advantage Member Benefits > Face-to face Care coordination for all members > 24 hour nurse line > Transportation to medical appointments > Disease management (diabetes, heart disease) > Smoking cessation program > Online health and wellness center > Member newsletter

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Blue Plus Commitment Blue Plus is committed to serving all people in the state of Minnesota. We are also committed to being part of the solution for managing the increasing costs to the health care system.

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Blue Advantage Contact Information Beth Nelson External Partnership Management [email protected] 651-662-6882

Melody Bialke Manager of Business Partnerships [email protected] 651-662-6420 www.bluecrossmn.com 12

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Blue Cross and Blue Shield of Minnesota is an independent licensee of the Blue Cross and Blue Shield Association

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