Program Overview
Patient Population
The 2024 BCBS MN Program services two plans: Minnesota Senior Health Option (MSHO) and Medicare Advantage w/ Part D prescription coverage (MAPD).
Purpose
The purpose of this program is to conduct encounters and perform interventions that drive improvement of adherence and statin use quality measures
Pharmacy Services (aka Tasks)
Quality Measures 🆕❗️
D08: Medication Adherence for Diabetes Medications
D09: Medication Adherence for Hypertension (RAS antagonists)
D10: Medication Adherence for Cholesterol (Statins)
D12: Statin Use in Persons with Diabetes (SUPD)
Pharmacy Payments
Pharmacy Services
Completed Task: addressed tasks that led to 1 or more clinical interventions.
Archived Task: addressed tasks that led to no clinical interventions by pharmacists
Quality Measure Outcomes 🆕❗️
Gap Conversion: converting members to a given measure numerator in the 2024 year who were eligible and did not achieve presence in the numerator at the end the previous year (2023).
Control Maintenance: maintaining a member in a given measure numerator in the 2024 year who also achieved presence in the numerator in the previous year (2023).
How to be Successful
For a more detailed overview of the 2024 BCBS MN Program, check out our success guide below. The guide includes additional information on patient-pharmacy assignment, patient targeting rules, workflow tips, optional scripting, and much more!