BCBS launches national high-performance network

December 22, 2020

​On January 1, 2021, the BlueCross® Blue Shield® (BCBS) System will launch the Blue High Performance NetworkSM (Blue HPNSM). This partnership with select providers supports employer groups in their efforts to improve health outcomes and keep costs manageable.

How are Blue HPN providers chosen?

BCBS identified national measures that align with industry standards to create a foundation and framework for continuous improvement of services and patient outcomes. They've also accounted for regulatory and state mandates, while tailoring the program to meet the needs of its top 55 U.S. markets.

In many markets, the Blue HPN is narrower than the broader PPO network; this means that not all PPO participating providers are part of Blue HPN. Blue HPN is a sub-set of BlueCard® PPO network in many Plan areas. At Independence, we will be utilizing our existing Personal Choice®/PPO Tiered Network (introduced in 2018). While this is not a narrow network, it is a tiered network: acute care facilities and ambulatory surgical centers are grouped into one of two in-network tiers, based on cost and quality measures. Members pay lower out-of-pocket costs when they receive care from tier one providers.

Exclusive Provider Organization (EPO) Blue HPN is supported by EPO products. Blue HPN members have access to in-network coverage in all Blue HPN markets. Independence Blue HPN members further maximize their benefits utilizing tier one Blue HPN providers in our service area.   

When in a non-Blue HPN market, patients are limited to urgent and/or emergent care at non-Blue HPN health care providers.

Treating Blue HPN patients

You can recognize patients with Blue HPN by the Blue High Performance name and the “HPN in a suitcase" logo on the member ID card. You can follow the same pre-service review and other procedures you use today for BlueCard PPO patients.

 

Patients will be guided to Blue HPN providers by their employer or other Blue HPN referring health care providers. You can find the network on our Find a Doctor tool.

You may also use the NaviNet® web portal (NaviNet Open) to determine your in-network benefit tier. 

Learn more

If you would like to learn more about Blue HPN, please contact our Provider Network Services team via email at pnsproviderrequests@ibx.com.

NaviNet® is a registered trademark of NantHealth, an independent company.