A female healthcare worker holds a patient's leg

Self-Funded Network Programs

About Our Care

Large, self-funded businesses depend on Blue Cross and Blue Shield of New Mexico for our expertise, quality, and range of options. Every day, we earn our reputation for generating sustainable cost savings, and offering networks of providers dedicated to quality and healthy outcomes. Your clients and their employees deserve more than a health care provider; they deserve a health care partner–that’s BCBSNM.

The Blue Distinction Program

Blue Distinction® is a designation given by Blue Cross and Blue Shield (BCBS) companies to health care facilities that have demonstrated expertise in delivering efficient, high-quality care with proven results, lower readmission rates and fewer complications. Blue Distinction Specialty Care provides distinguished quality care in the following 11 areas:

  • Bariatric Surgery
  • Cancer Care
  • Cardiac Care
  • Cellular Immunotherapy (CAR-T)
  • Fertility Care 
  • Gene Therapy for Ocular Disorders
  • Knee and Hip Replacement
  • Maternity Care
  • Spine Surgery
  • Substance Use Treatment and Recovery
  • Transplants

Blue High-Performance Network® (BlueHPN®)

Designed to deliver greater value for companies and employees, the Blue High-Performance Network (BlueHPN) gives employees portable access to care across 65+ major markets—more markets nationwide than competitors.

  • Employers that choose BlueHPN average more than 10% in additional savings1 as compared to our already industry-leading PPO.
  • Providers in BlueHPN are measured on a consistent set of quality metrics across four key domains2.
  • Discover why businesses looking to tailor a cost-conscious benefits package with access to high-quality health care services choose BlueHPN.

Total Care

  • Total Care is a national designation program that recognizes providers for their efforts in coordinating total patient care and focusing on wellness and prevention. Blue Cross and Blue Shield (BCBS) Plans partner with these providers to improve health outcomes for members and curb the rising cost of healthcare.
  • Most Total Care programs are primary care models. Providers belong to Accountable Care Organizations (ACOs) and Patient-Centered Medical Homes (PCMHs). The ACOs and PCMHs must perform against both quality and cost outcome targets to receive incentives and rewards.
  • Employers have the flexibility to provide 2 or 3 configurable tiers or custom benefit designs, effectively steering members to designated providers.

We Innovate with Purpose

We’re constantly evolving our products to reach even higher standards for care, quality, affordability, and accessibility. We drive innovation from a deep integration of advanced analytics, expert insights, and leading-edge technology to advance better health outcomes for your client, their employees, and the health care industry. From digital tools and mobile applications to incentive programs and groundbreaking coverage options, we are transforming the health care industry as we enable better health, smarter care, and more meaningful connections between our members and providers.

 

1 Savings are based on Consortium Health Plans analysis, 2019. Savings are on average and assume 100% enrollment. Results will vary based on employer locations and implementation.
2 Measures align with those being utilized by credible industry organizations, including American Hospital Association, Catalyst for Payment Reform and America’s Health Insurance Plans.