How We Create Value

Quality Blue Primary Care (QBPC) Disease Care Management

Launched in 2014, QBPC is a Blue Cross and Blue Shield of LA population health and quality improvement program designed to improve the overall health of the population.

• Hypertension - Patients with a history of hypertension on one or more medications for hypertension are considered “hypertensive” for QBPC purposes regardless of blood pressure reading(s).
• Chronic Kidney Disease – Patients with a decline in kidney function for three or more months - as determined by an estimate of the Glomerular Filtration Rate (eGFR) of less than 60 mL/min/1.73 m2 OR significant albuminuria NOT on any form of renal replacement therapy including kidney transplant - are eligible for QBPC enrollment.
• Diabetes Mellitus - Patients with a diagnosis of type 1 or type 2 diabetes mellitus on one or more medications, either oral agent(s), insulin(s), or other anti-hyperglycemia medications are eligible for QBPC enrollment. Prediabetes, metabolic syndrome or other pre-diabetic syndromes are not eligible for QBPC enrollment. Patients who are co-managed with an endocrinologist may be enrolled in QBPC.

Appropriate Emergency Department Utilization — Reducing ED visits for non-urgent or primary care-treatable issues

Blood Pressure Control — Striving for optimal compliance with pharmacotherapy

Cost-Effective Pharmacy Utilization — Making sure the safest, most cost-effective drug is chosen and ensuring proper use