Keeping Costs Low

Coordinating Care

Working With Physicians and Hospitals | Controlling Prescription Drug Costs

When Wellmark Blue Cross and Blue Shield members face challenging or long-term medical conditions, our case managers step in to coordinate access to the appropriate and cost-efficient, medical care. The National Institute for Health Care Management estimates case management returns a value of $1.40 to $2.90 for every $1.00 spent.

Wellmark’s case managers are linked to medical experts throughout the United States. We have immediate access to hundreds of medical directors at other Blue Plans across the country. This access allows us to coordinate care for members outside of Iowa and South Dakota.

Transplant center national network

Case managers also have access to the Blue Quality Centers for Transplant (BQCT) that offer comprehensive services through coordinated, streamlined referral management. All of the centers in the BQCT network meet specific participation criteria that consider:

• Provider qualifications
• Program process
• Patient outcomes

These centers, in agreement with the BQCT, provide transplant services at favorable rates.