OP4 Prioritization of ADT Notifications Improves Efficiency of New Blue Cross and Blue Shield of Louisiana Care Management Referral Process

Abstract

Blue Cross and Blue Shield of Louisiana in 2018 began receiving daily admission-discharge-transfer (ADT) notifications to develop a clinical intervention program. To improve management of resources and increase the efficacy of outreach efforts, Blue Cross developed a daily selection algorithm to prioritize members with the highest risk, highest cost, or frequent use of emergency departments, and who are most likely to respond positively to clinical intervention. Prioritized outreach began December 2021 and is ongoing.