Blue Cross Blue Shield of Minnesota (BCBSMN) and American Healthways partnered to create Blue Print for Health, a broad-based care enhancement program that's boosted access to care, slashed costs, and enhanced physician and patient satisfaction. Among the results: declines in hospital and ER visits, a 2.9% ROI, and more than $20 million in cost reductions.

The Tallahassee, Fla.-based Agency for Healthcare Administration (AHCA) and LifeMasters Supported Self-Care built a customized disease management program to target and manage the chronic conditions of some 8,000 Medicaid recipients. Focusing on congestive heart failure (CHF), as well as related conditions and co-morbidities, the program has already reduced Florida Medicaid costs by $12.6 million-a 16.3% decline.

The Primary Care Access Network (PCAN) of Orange County, Fla., has improved access, education and patient flow for the uninsured and underinsured. With a volunteer network of some 800 medical professionals donating more than $2.5 million in uncompensated special care, PCAN enrolled 25,000 patients in 2003, while delivering education to 3,000 residents.

Ground partnership decisions in research . Research conducted prior to the formation of PCAN revealed that Orange County had the highest percentage (of population) insured-21.9%-but the lowest number living in poverty. "These people were working poor," says Larry Jones, Director of Orange County's Health and Family Services Department, "and that became a real selling point for our local political leadership."

Ensure equal contributions . Effective partnerships offer all stakeholders an opportunity to share ideas. In the case of the BCBSMN/American Healthways partnership, American Healthways staff met with physicians to demonstrate how its nurses could help patients manage chronic disease. Physicians then had the opportunity to choose information they wanted to receive before each clinic visit.

Assign roles based on strengths and experience . In delivering DM to Medicaid beneficiaries, state agencies such as AHCA typically identify potential participants by examining claims data. In the AHCA/Lifemasters partnership, AHCA offered LifeMasters the role of contacting beneficiaries. Lifemasters' field staff then located 80% of those individuals who were deemed unreachable.

Focus on purpose and mission . "These are very committed, highly ethical healthcare leaders who want to make the system better," says Bill Gold, MD, chief medical officer and vice-president of BCBSMN, in speaking of the partnership. Also critical, say partnership leaders, is development of a set of ground rules on how partners will treat one another and communication of any changes within the partnership to each partner.

Tap resources beyond the existing partnership . In the process of clinic development, the PCAN partnership discovered the advantage of partnering with federal community health centers. These Federally Qualified Health Centers (FQHCs) have the capability to see all patients, regardless of payer source, according to PCAN officials. MHE