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Measuring and Improving the Effectiveness of Wellness, Disease & Care Management Teams: A Blue Cross Blue Shield of Michigan (BCBSM) Case Study

Blake T. Andersen, PhD, CEO, HealthSciences Institute and Michelle Fullerton Michelle Fullerton, BA, BS, CCM, CCP Director, Wellness, Care Management and Health Promotion Blue Cross Blue Shield of Michigan (BCBSM)

Learning Objectives

- Summarize why developing and measuring staff proficiency in MI is key to better program outcomes.
- Discover why most motivational interviewing (MI) training programs fail to deliver expected value.
- Detail a best practice approach for building staff proficiency in chronic care and MI.
- Describe how the validated Health Coaching Performance Assessment (HCPA) has been used to benchmark and improve performance.
- Summarize practical steps for addressing staff, operational and administrative barriers to program improvement.

For over two decades, Dr. Andersen has been a leader in health psychology, chronic care improvement, health-related behavior change, health care performance improvement and workforce development. He received a PhD in psychology from MU-Columbia, served on the clinical faculty at the USF College of Medicine, where he completed a post-doctorate in health psychology, and achieved certification as a Senior Professional in Human Resources (SPHR). He was an organization development team leader with Arthur Andersen Business Consulting in Chicago, leading strategic human resource, change management and workforce learning engagements for multinational companies. Dr. Andersen has led a number of regional health systems change initiatives in states including Minnesota, Wisconsin and Florida. He recently designed and delivered physician practice performance improvement learning programs and tools for ImproveHF, the largest outpatient heart failure performance improvement study to date in the US.

Michelle has worked in the care management field at BCBSM for the past 10 years. BCBSM serves four million members across the US and within the State of Michigan. Over the past ten years, BCBSM care management programs have expanded to include chronic condition management, 24/7 nurse call line, smoking cessation, care transition to home, and wellness coaching. A total of 280 nurses, physicians, social workers and dietitians support these programs. Fifty-percent of the clinical staff work within a work from home environment. All clinical programs are administered by BCBSM. Michelle obtained her nursing degree from the University Of Windsor, Ontario Canada. Previous experience includes hospital case management, utilization review, oncology nursing and emergency services. She also has a degree in Communication Studies and worked in advertising prior to becoming a registered nurse.

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