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STATE'S LARGEST INSURER SEES DROP IN C-SECTION RATES AFTER SHARING INFORMATION WITH PHYSICIANS AND CHANGING REIMBURSEMENT POLICY

 ST. PAUL, Minn., Oct. 27 /PRNewswire/ -- An 18-month study covering six years of cesarean delivery rates by Minnesota's largest health carrier shows that using data in the quality improvement process encourages safer baby deliveries and lowers health care costs.
 "Our sophisticated data analysis capabilities allow us to work constructively with our participating physicians so they can improve their practice of medicine," said Steve Richards, M.D. Richards is vice president and medical director of Blue Plus, Blue Cross and Blue Shield of Minnesota's (BCBSM) HMO affiliate, and managing director of the company's Project HealthVision Research Unit. "Our data is offered as a feedback tool. We work together with providers to look at patterns of care and allow them to implement changes that can lead to the better health of our members."
 In some areas of the state, BCBSM found cesarean delivery rates were higher than 40 percent, while in other areas rates were lower than 8 percent. The area reporting some of the highest rates was northeastern Minnesota.
 BCBSM found that cesarean delivery rates were higher largely due to physician fear of malpractice claims, a universal desire to speed the delivery process, patient preference and differences in rates of reimbursement between cesarean and vaginal deliveries.
 Blue Plus, which covers nearly 200,000 members statewide, began addressing the wide variance in January 1990 by teaming with the clinics and hospitals in northeastern Minnesota to share the findings and develop a cooperative effort to investigate the causes for the higher rates.
 At the same time, Blue Plus began phasing in a new reimbursement policy that equalized payments to physicians for cesarean and vaginal deliveries. By January 1992, the reimbursement change became effective for all Blue Plus physicians. Blue Plus cesarean delivery rates, which were 18 percent in 1991, dropped to 16 percent by the end of 1992.
 BCBSM began implementing the reimbursement change across all lines of business in July 1991 and continues to phase in the policy. BCBSM has seen the rate of C-sections among its patient members decrease statewide from 21 percent in 1991 to 18 percent in 1992.
 Nationally, the average cost of a cesarean delivery is $7,826, or two-thirds more than a vaginal delivery. The Centers for Disease Control and Prevention's (CDCP) benchmark rate for C-sections is 15 percent by the year 2000.
 "Our sharing of information and changing reimbursement to encourage more vaginal births have led to fewer cesareans, lower costs to families and, most importantly, safer deliveries," said Richards.
 How Was The C-Section Rate Variance Discovered?
 BCBSM measures and compares health care services for defined populations using a proprietary computer software data system called Small Area Analysis (SAA). Using SAA, patterns of care and outcomes are traced to specific clinics and hospitals. This process allows BCBSM to locate communities within Minnesota where cesarean delivery rates are unusually high or low. BCBSM then feeds this information back to local physicians and administrators so they can identify reasons for the rate variance and in turn improve their practices.
 Implementing programs to decrease unnecessary cesarean deliveries is part of Project HealthVision, a system for using data to change the way health care decisions are made, ultimately improving health care delivery and controlling costs.
 Serving nearly 1.2 million Minnesotans, BCBSM is the state's oldest and largest health coverage carrier. Nearly one-quarter of all Minnesotans are covered by the carrier and its affiliated organizations. The company is celebrating its 60th anniversary in 1993.
 -0- 10/27/93
 /CONTACT: Mark Heymans, 612-456-8786; or Karl Oestreich, 612-456-1502; or Judy Kerry, 612-456-1515; all of Blue Cross and Blue Shield of Minnesota/


CO: Blue Cross Blue Shield ST: Minnesota IN: INS MTC SU:

CP-DB -- MN004 -- 7207 10/27/93 10:58 EDT
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Publication:PR Newswire
Date:Oct 27, 1993
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