Blue Shield of California’s new CEO, Mike Stuart, brings a finance background to the chief executive role, not only as a payer, but as the former CFO of a safety-net health system.
“Working in multiple parts of the health industry has helped me develop a better systems approach, understanding the different components, both from a delivery system perspective and the health plan side of things,” Mr. Stuart told Becker’s. “They’re all interrelated. I believe I’ve benefited from having a pretty deep and thorough understanding of how each of those components works and how they work together. It’s critically important now when you’re trying to solve a great challenge like affordability. It requires all the pieces working together in concert.”
Mr. Stuart was named Blue Shield of California’s permanent CEO on Aug. 26 after serving in the role on an interim basis since March. He has been with the company since 2014 and served as CFO since 2022. Before joining the payer, he was CFO of Redwood City, Calif.-based Daughters of Charity Health System.
He said that as CEO his priorities are centered around ensuring the payer’s members and communities have access to high-quality, affordable care. He said rising costs that affect the affordability of care is the No. 1 challenge he’s seeing right now, adding that one of the biggest concerns is the effect affordability — or lack thereof — has on access to care.
“With my prior experience at what I call a safety-net health system, I saw firsthand what happens to people over time when they don’t have access to care and (when) they ultimately do find it,” he said.
“We need to do a better job of getting people access to care much earlier, so we can be much more preventative and maintain the health of the population versus ending up in a situation where the events are much more acute, likely more preventable in the first place, certainly more expensive to the entire industry and ecosystem.”
In addition to putting a heavy emphasis on improving health outcomes, Mr. Stuart said the company is also focused on “providing an exceptional experience.” He said members increasingly want a digital first experience. Blue Shield’s digital strategy is geared toward making access easier, care more affordable and outcomes better “particularly as predictive analytics allow us to be proactive when members need us most.”
“We’ve built for our members a comprehensive digital health record, pulling data from multiple data sources, not just one provider. We’ve developed, with parts of our provider network, shared decision making models with a digital tool that helps members and their providers go through decision-making on some of their clinical options and then things such as both online scheduling for our members through our mobile app, but also coordinating and linking that to our providers, many of whom are doing a big push on online scheduling to help with the access to care issue.”
Blue Shield is also in the midst of rolling out automated, real-time prior authorizations and are working on innovative and better payment models.
“We’ve been on a push for many years on expanding our reach on value-based contracting. We’re now in the next iteration of those. We believe a big portion of that is co-designing those innovative payment models with our providers. We think we can do it faster when we do it together.”
A challenge as large as the affordability crisis is going to take the entire healthcare industry to fix, Mr. Stuart said.
“The more integrated, the more aligned we are with like-minded provider partners, the more success we are going to have.”
