One of the perks of
giving keynotes all over the country is being able to hear what other health
care leaders are saying without having to pay the conference fees. One of my major keynote themes is that
everyone (patients, doctors, hospitals, employers, and health plans) will have
to change in order to thrive during the current health care delivery system
transformation.
Recently in Delray
Beach, I stayed after my keynote to hear Florida Blue CEO Patrick Geraghty
describe his first year of trying to change the Blue Cross/Blue Shield
franchise to respond to health care reform. I have written elsewhere about the health plan response to
the changing environment (http://thehealthcareblog.com/blog/2012/07/22/health-insurers-the-affordable-care-act-extinction-or-reinvention/), but Geraghty’s speech highlighted how urgent
and how difficult change can be when an industry business model is disrupted by
federal legislation and market forces.
Geraghty has led the
Blues effort in Florida to update their name, mission, vision, and values. Focus groups revealed that the new name
Florida Blue was easier to say and communicated a less corporate, more friendly
image than the old name Blue Cross Blue Shield which brought to mind adjectives
such as corporate, distant, and expensive.
A four paragraph mission
statement was replaced by a single sentence: “To help people and communities
achieve better health.” The
vision statement was rewritten to now describe the company as “a leading
innovator enabling healthy communities.” The five corporate values now include the familiar
“respect,” “integrity,” and “excellence,” and the more unusual “courage” and
“imagination.”
What I found most
intriguing and revealing was how these new efforts are being translated into
concrete tactics such as opening retail centers and partnering with Disney on a
new innovation institute.
Florida Blue recognizes
they must engage consumers in the new world of Affordable Care Act Insurance
Exchanges, and they have opened retail stores so that there is a center within
25 minutes of 80% of their membership. These stores do more than just sell insurance and
resolve claims problems. They
also:
- · Teach people to use online tools such as iPads and smartphone health apps
- · Provide health and wellness services such as health risk assessments
- · Engage and educate legislators at the store in the state capital
- · Host programs where book donations for school kids are tied to the number of points scored by the Miami Heat and the Orlando Magic
- · Act as starting and finishing points for fitness runs
Partnerships with Disney
include both a kids’ center at the Disney World’s Epcot and a new health care innovation
institute. Geraghty said that the kids’
center will feature health and wellness games and exhibits and that 500,000
visits a year can be anticipated.
He was also happy that Disney chose Florida Blue to join GE, Johnson
& Johnson, and Cisco as partners in the state of the art innovation center.
Geraghty described how
his Accountable Care Organization (ACO) experiment with Baptist Health South
Florida differed from the federal Medicare Shared Savings Program. By reducing the 64 quality metrics in
the federal program to 15, he believes they have created a more flexible and
workable model.
Florida Blue’s ACO
elements of success include:
- · Trust between all the parties involved
- · Data transparency
- · Meaningful quality measures
- · All parties having vested interest in success of program
- · Shared savings aligns with best interests of the patient
It is still an open
question whether health plans can evolve fast enough to be successful in the
newly emerging health care world. At least one question to Geraghty in the
question and answer session reflected skepticism on the part of hospital
leadership to be able to truly trust a health plan. “They are among the most disliked industries in the United
States” according to Harvard professor Regina Herzlinger. Another
expert, Fred Karutz of Silverlink Communications, thinks that health care
insurance companies have a long way to go because they are new to the retail
environment. “As people become consumers, they seek out value. In the group
space, health plans could never hear the consumer scream, but in the retail
space everybody can hear the consumer scream.”
Florida Blue seems to be responding to this new retail
challenge with imagination and focus. Time will tell if they are successful in
becoming an effective and trusted partner to patients and providers in a
transformed clinical delivery system.
