Community Blue - BlueCross BlueShield of Louisiana

Program Location: 
Baton Rouge, LA
Payer Type: 
Blue Cross and Blue Shield of Louisiana

Community Blue offers comprehensive, coordinated, patient-centered care for people in the Baton Rouge market, including East Baton Rouge, West Baton Rouge and Ascension parishes. Members have a select network of doctors and providers from within the BlueCross network to choose from, and in exchange pay lower premiums.  The core of this product is a patient-centered medical home model that makes the doctor-patient bond stronger by replacing fragmented, disjointed and reactive care with care that is accountable, coordinated, collaborative and comprehensive care around a long-term healing relationship with their personal physician. Each patient is connected with a primary care physician who leads a team with shared medical service duties, providing for the patient's healthcare needs and working with other medical providers when more support is needed.

Payment Model: 
  • Base payment of FFS & capitation PMPM
  • Shared savings of 50-74%
  • Care coordination payment for participation
  • Care coordination payment for infrastructure
  • Increased PMPM for accreditation 
  • Plan pays care manager/nurse practitioner directly for care management incentive
  • Pay for outcomes bonus payment
Cost Savings: 

First-year results show that it’s working. Most participating physician groups successfully cut spending and improved healthcare quality. On average, they saved 1.7% in their total healthcare costs. The most successful groups saved 3.8% on average.

Last updated March 2019
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