Focusing on Preventive Care and Chronic Conditions

BCBSTX is an ally to its strong networks of community doctors, hospitals and other providers who deliver care to more than 6.9 million members. We employ doctors, nurses, social workers and pharmacists who help ensure members get the care they need. In 2022, these clinical teams expanded an initiative targeting six areas that have a major impact on quality of life and health outcomes: cancer screenings, immunizations, diabetes, cardiovascular care, behavioral health and maternal and infant health.

Part of the work involves using claims data and other information to identify members in need of recommended services and screenings and facilitate a variety of interventions in collaboration with their providers.

The initiative also includes steps to reduce emergency room visits and hospitalizations and to enhance coordination among the doctors and others caring for our members. And to help overcome barriers to care known as social determinants of health, we’re meeting meet members where they are with programs deeply rooted in our communities.

In 2022, BCBSTX used retinal cameras at large community events and at doctor’s offices to perform eye exams on members with diabetes, which can damage blood vessels in the retina and cause blindness. We also texted certain members with gaps in their breast cancer screenings to encourage and help them schedule mammograms.

In another initiative, BCBSTX offered free at-home colorectal cancer screening tests to targeted member populations. The fecal immunochemical test (FIT) kits are an effective and less invasive screening for colorectal cancer. “All of our efforts are really predicated on members establishing meaningful relationships with our provider partners,” says BCBSTX Vice President and Chief Medical Officer Dr. Mark Chassay.

Investing in Community-Based Resources

Community-based organizations play a vital role in providing access to care and helping people overcome barriers such as lack of transportation, lack of insurance and financial hardship. Many of the grants BCBSTX provided in 2022 helped these organizations deliver preventive care, primary care and mental health services. 

One grant has helped El Paso Children's Hospital provide inpatient and outpatient pediatric Type 1 diabetes education services to hundreds of families across Southwest Texas and Southeast New Mexico. 

Blue Bear visits a patient at El Paso Children's Hospital, where a BCBSTX grant helped expand pediatric Type 1 diabetes education services.

The funding allowed the program to add two outpatient educators who help children and families learn to manage and cope with the disease. 

“As the kids grow up, it’s really neat to see how impactful the program is,” says Amanda Timmerman, the hospital’s clinical nutrition and pediatric diabetes education manager.

“It’s highly individualized to each patient’s needs.” Bexar County’s Community Health Collaborative received a grant to add community health workers in rural and isolated areas with health provider shortages. 

They link people to health and social services, including diabetes care and education, transportation, food programs and child care. The community health workers are trusted sources because they also have struggled to apply for government programs or find access to care, says Elizabeth Lutz, the health collaborative’s executive director. Now they’re a bridge to help others get the services they need. 

A rising number of women are experiencing complications during pregnancy and childbirth in the U.S., and the numbers are especially high among Black women. With targeted grants, BCBSTX is supporting innovative approaches to addressing the crisis in maternal and infant health. 

Although complications from pregnancy-related hypertension are preventable, many women aren’t treated for the condition. To address this critical issue, BCBSTX invested in the March of Dimes Houston’s effort to distribute hundreds of hypertension kits to maternal health providers across the state. Those providers worked with patients to use blood pressure cuffs at home to identify issues between prenatal visits. “Pregnant women need to be empowered with the knowledge and tools to monitor their own health,” says Heather Butscher, the organization’s maternal and infant health director.

Helping People Get Coverage

BCBSTX is the largest provider of health benefits in the state, working with more than 140,000 physicians and health care practitioners and more than 520 hospitals to serve more than 7 million members. We provide a broad spectrum of coverage options for employers of all sizes, individuals and families, Medicaid and Medicare.

We maintained our longstanding commitment to offering consumer options in all 254 counties. For the second year in a row, we expanded our reach in Medicare Advantage, focusing on providing access to care in rural and underserved areas. The Medicare expansion brings 2023 coverage options to 38 new counties and adds 31,000 providers to the BCBSTX network to ensure Medicare members have access to care when and where they want and need it.