Blue Shield of California is working with big tech companies to provide an improved digital experience for members and better coordinate their care, its chief technology officer told Becker's.
The payer, the third largest in the state, last year launched the Care Connect care management platform, which provides live updates on its highest-need members so its clinical team can easily view information like their chronic conditions, immunizations and medications.
"We've roughly doubled the amount of members that we can serve," Bill Giard, vice president of enterprise architecture and innovation at Blue Shield of California, told Becker's. "That includes a sevenfold increase in the number of special-needs members covered by care management."
Care Connect is a partnership with Salesforce that uses Blue Shield's Experience Cube data hub, which is hosted by Microsoft.
"We are applying technology in the right way to really automate … and collaborate together to be able to define the care plan and understand what the member needs," Mr. Giard explained. "What are the barriers to health? What's their health risk assessment? How do we deliver care that they need — it may be outpatient services, at-home services, transportation services — and really address the whole list of population health needs?"
Blue Shield of California aims to provide a smooth, interactive digital platform — for employees and members alike — that many other sectors have perfected. Mr. Giard worked for Intel for more than a quarter-century before joining Blue Shield in 2021 and is trying to bring some of that tech-company mindset to healthcare.
"There is a real need in the healthcare industry to modernize a lot of the digital channels," he said. "So that's an ongoing evolution of enhancements."
Blue Shield also hopes the centralized, streamlined database can help with things like prior authorizations and claims processing. Mr. Giard noted that administrative tasks cost the healthcare system hundreds of billions of dollars per year.
"Our strategy is to really transform healthcare, to get as much of that administrative overhead as seamless as possible, and deliver that real-time experience for our members and get them care when they need it," he said, whether it's "virtual, primary care, health at home."