Insurers do not have to own every part of the healthcare system to improve connection, according to Jim Boyman, vice president of GuideWell Health.
GuideWell is the parent company of Florida Blue. In December, the company launched an initiative to manage cancer care for Florida Blue ACA members. Through a partnership with Cerritos, Calif.-based The Oncology Institute and primary care organization Sanitas, Florida Blue members diagnosed with cancer will be connected with an oncology team to manage a personalized treatment plan.
"Everyone talks about how fragmented healthcare is," Mr. Boyman told Becker's. "This shows how you don't necessarily have to own all parts of the system to reduce that fragmentation. You can use technology and relationships to collaborate and overcome fragmentation through programs like this."
The program is for members enrolled in Florida Blue's individual plans. In 2024, Florida had the largest number of ACA enrollees of any state.
In the model, the members' primary care physician acts as the "quarterback," Mr. Boyman said, helping manage cancer care as well as the individual's overall physical and mental health. Florida Blue | Sanitas Medical Centers, a joint venture between GuideWell and Keralty, operates more than 50 clinics for Florida Blue members in the state.
Individual members can be more difficult to engage than those in the employer-based market, Mr. Boyman said.
"Despite those challenges, the shared values these organizations have, and the shared goals, really help navigate all those complexities and get us to a program that is really focused on centering the member experience," he said.
The model launched in four markets in December, with the goal of scaling beyond that, Mr. Boyman said. The company will track member engagement and outcomes to measure success, he said, but by at least one measurement, it is already successful.
"The immediate success that we get right off the bat is the structure of the arrangement to focus on outcomes, not services. That in and of itself is a success," he said.
GuideWell and Sanitas launched their joint venture in 2014. The two organizations drive tight coordination with primary care and member experience, Mr. Boyman said.
"I think this program is a really good model, and a prime example of how we're transforming healthcare by focusing on what matters most to our members, which is access, affordability and outcomes," he said.