Blue Cross and Blue Shield of Texas Shared Best Practices for Texas Health Steps (THSteps)

In 2021, Blue Cross and Blue Shield of Texas (BCBSTX) Medicaid Quality Team created a new role and hired a Clinical Practice Consultant (CPC). The CPC is a liaison for providers and quality initiatives, such as Performance Improvement Projects, HEDIS® projects, and maximizing member health. The CPC has met with 25 different provider groups over the past six months reviewing rates and obtaining best practices utilized by provider offices to better serve their population. 

Best Practices:

BCBSTX Medicaid’s Quality team is excited to share some of these best practices developed by our providers for THSteps and well child visits to aid in improving the outcomes of our members.  

  • Monthly member outreach calls and texts for well child visits from the provider’s staff one month prior to the member’s birthday to ensure annual well visits are scheduled and performed has proven effective for our members.
  • Provide well visit appointments within a week of outreach calls is an added convenience to our members and enhances the opportunity to get a timely visit scheduled.
  • A common practice of one of the largest pediatric providers in the Austin area is to perform a well child visit during a sick visit.  This practice is to ensure the well visit is performed to enhance the member’s health outcomes.
  • Scheduling the annual well child visits before the member leaves the clinic is a beneficial method to incorporate into practice.  One provider group places an action item in the electronic medical record (EMR) when the appointment is scheduled, which prompts call-back alerts to the provider staff to call and remind the member of the upcoming well child visit appointment. 
  • Ensuring annual well visits are completed for members with chronic conditions improves and enhances outcomes. To reduce emergency department utilization and improve chronic conditions, follow-up phone calls after a sick visit involving a chronic condition are vital. 
  •  Making health care access more convenient for our members is important for those with busy schedules.  Offering short wait times and extended office hours for all member appointments adds convenience for the member and their family’s schedules.
  • One of our provider groups has created a Texas Health Steps (THSteps) template within their EMR system.  This template incorporates the THSteps periodicity schedule and the State THSteps visit forms.  The template facilitates adding fields with ease.  This tool makes THSteps charting very efficient, improves member outcomes, and contributes to increased provider quarterly compensation.
  • Incorporate deliberate outreach to all new members during their first month of attribution improves well child visit metrics.  The initial THSteps well child visit is to be performed within the first 90 days of enrollment and with the addition of the outreach calls, enhanced outcomes may be achieved.

Do you have best practices you would like to share with our provider groups to improve metrics and best patient-centered outcomes?  Please feel free to reach out to our Clinical Practice Consultant Lori Novicki, MSN, APRN-CNP, Quality Improvement, Texas Medicaid by email or phone at 1-512-231-7662.

The Texas Health Steps website offers up-to-date information on periodicity schedules, checkup components, and trainings as resources to providers.


Reference and review the BCBSTX Preventive Care Guidelines (PCGs), Clinical Practice Guidelines (CPGs), and THSteps for Medical Providers which includes all current vaccine schedules, ImmTrac2, and other important guidance for treating your patients.