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Rethinking Health in the First Year Marked by Expansion, Accessibility, and Innovation | California Blue Shield




Last year, Blue Shield undertook an ambitious effort to improve access to quality, affordable healthcare through Health Reimagined.Started

Peter Long

There are 20 pilot programs in four counties, Butte, Sacramento, Monterey and Los Angeles, now available state-wide to both members and the community.

Part of this work was included in the program roadmap from the beginning, but part of this work was unmet needs highlighted during the COVID-19 pandemic, such as widening racial disparities in health. Promoted to adapt to.

And there are many more things to come.

By focusing on holistic health and addressing social determinants to improve overall health and well-being, we have achieved the following successes:

Community Health Advocates: What began as a pilot program to connect Sacramento patients with unmet social needs

Kenneth Lee found his home after working with one of the Blue Shield of California community health advocates.

Addressed transportation, finance, food and housing gaps. Today, there are nearly 20 advocates throughout the state, referencing nearly 5,000 patients to local community services. Overall, physical health support was most sought after, but the social services required by region are: Sakurament: Mental / Behavioral Health (21%) Monterey: Physical Health (33%) Butte: Transportation (21%) Los Angeles: Mental / Behavioral Health (25%) and Mental Health Offering: ScaleLA: 2020 In the fall of the year, the Blue Shield of California Promise Health Plan announced a $ 900,000 donation to the ScaleLA Foundation to fund a two-year initiative condemning behavioral challenges. Health; Helps school officials, families and teens identify key indicators to better support adolescents’ mental health. Improve care coordination and service delivery for trauma-affected families. Early results from the student-teacher feedback loop show that the collaborative design process is working, and learning will be leveraged for future scaling efforts. BlueSky: In the fall of 2019, we embarked on a journey to support youth mental health through parents, educators and youth. And due to the stressors that the pandemic has brought to students, Blue Shield has invested more in mental health through collaborations such as: A campaign in which 48,533 young people shared 74,129 tips on how to deal with stress. Of those participants, 87% said they would advocate more mental health resources at school. Youth mental health first aid training for 2,000 educators and caring adults to learn crisis response. This increased confidence in helping adolescents in future mental distress (20% to 73%). Wellness Together provided counseling in 20 middle and high schools, producing nearly 7,000 counseling sessions. These sessions increased confidence in young people that they could express their feelings to others, feel emotionally strong, and build more relationships with others (an average increase of 20%).

What’s Next for Holistic Health? We are continually expanding our Community Health Advocates program, including extensions to the Wellvolution platform to assist members with type 2 diabetes. In addition, we are strengthening technology to help members connect with the healthcare system beyond clinical means, such as home care.

We have begun to rebuild the system so that the patient is at the center. As a result, we needed high-tech, high-touch support, including tools, time, and space for meaningful medical visits and conversations. The achievements in this area are as follows.

mySidewalk: We have relied on technology to support the work of community health advocates. Announced in the fall of 2020


In collaboration with mySidewalk, we have created the Neighborhood Health Dashboard. This is a tool that the general public has created together to better understand the surrounding community and its social needs. The project led to the development of 80 and received the 1st Innovation Award from the Healthcare Services category. Real-time billing: Advances in billing technology have created member transparency and choices, reducing the administrative burden on physicians in real-time billing operations. With the help of the OODA Health platform and the Dignity Health network, we have taken a state-wide initiative to serve more than 20 hospitals using Sacramento’s two hospital systems. Cricket Health: In 2020, through collaboration with Cricket Health, we continued home and telemedicine options for members of late-stage chronic kidney disease. Together, we were able to provide members with educational tools to give them choices in their treatment plans, as well as support from peers and a team of medical professionals. Virtual Transcription / Consultation and Care: Added virtual transcription and virtual consultation to treat patients quickly and safely in a pandemic.

What’s next for tech and high touch support? We continue to identify ways to leverage technology to transform care, personalize it to patients, ease the burden on physicians, and comprehensively assess and address social and systematic issues. I will. Some of our pilot programs work on the health of black mothers through collaboration between Sacramento and technology companies and community organizations in the Los Angeles region. In addition, we learned a lot from testing the solutions individually. The result is that the solution is packaged in an integrated way. These customized solutions will continue to evolve to maximize the impact of these products and meet the needs of members, providers, and communities.

We are using technology to improve personal care through these initiatives:

Health Information Exchange: After working with Manifest MedEx for some time to establish a state-wide health information exchange, Governor Gavin Newsom answered the phone in January 2021. Decision Sharing: I believe patients have the right to feel empowered to choose their treatment plans. For these reasons, we started a pilot program at WiserCare to work on childbirth planning for pregnant mothers and treatment planning and medication education for diabetics with wellvolution. Launched Primary Care Reimagined in September 2020, a new reimbursement model that provides a group of physicians in the network with access to a range of the latest technologies to enhance care delivery and provide more predictable cash flow to physician practice, especially during a pandemic Provided. And now we are pleased to announce that our original participation goal of registering 100 practices has been achieved and exceeded.

What’s Next for Personal Care? Primary Care Reimagined will include more providers in 2021 and will continue to rethink other areas of the system, such as pharmacy care and behavioral care.

Peter Long is a Senior Vice President and Chief Healthcare Transformation and Affordable Officer at the Blue Shield of California.

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