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Health Reimagined First Year Marked by Expansion, Accessibility and Innovation

Last year, Blue Shield committed to an ambitious effort to improve access to quality, affordable healthcare through Health Reimagined. It began

Peter Long

with 20 pilot programs in four counties – Butte, Sacramento, Monterey, and Los Angeles – and has grown into statewide offerings for members and communities alike. 

And while some of this work had been on the program’s roadmap from the start, some of this work was expedited to adapt to unmet needs highlighted during the COVID-19 pandemic, including the increasing racial disparities in health. 

And there’s more to come. 

Through our focus on holistic health, addressing social determinants to improve one’s overall health and well-being, we saw success with

  • Community Health Advocates: What started as a pilot program to connect Sacramento patients with unmet social needs, has 
    Kenneth Lee found a home after working with one of Blue Shield of California's community health advocates.
    addressed gaps in transportation, finances, food, and housing. Today there are nearly 20 advocates deployed across the state who have referred close to 5,000 patients to community services in their area. Overall, physical health assistance was most sought out, but here’s what social services were requested by region: 
    • Sacramento: Mental / behavioral health (21%) 
    • Monterey: Physical health (33%) 
    • Butte: Transportation (21%) 
    • Los Angeles: Mental / behavioral health (25%) and food assistance
  • Mental health offerings
    • ScaleLA: In Fall 2020, we announced the $900,000 donation that Blue Shield of California Promise Health Plan made to the ScaleLA Foundation to fund a two-year initiative to destigmatize challenges associated with behavioral health; help school officials, families and teens identify key indicators to better support youth mental health; and improve care coordination and service delivery for families affected by trauma. Early results from feedback loops with students and teachers have shown that the co-design process has worked, and the learnings will be leveraged for upcoming scaling efforts.  
    • BlueSky: We began our journey in supporting the mental health of youth through parents, educators, and youth in Fall 2019. And with the stressors the pandemic brought to our students, Blue Shield invested more in their mental health through collaborations, like:  
      DoSomething Crowdsourced Guide V2
      • DoSomething campaign where 48,533 youth shared 74,129 tips on how to handle stress. Of those participants, 87% of them said that they would advocate for more mental health resources at their schools.
      • Youth Mental Health First Aid trainings for 2,000 educators and caring adults to learn crisis response, which increased their confidence in assisting a youth in emotional distress in the future (from 20% to 73%). 
      • With Wellness Together, we implemented counseling in 20 middle and high schools, generating nearly 7,000 counseling sessions. These sessions drove increased confidence in youth to express emotions to others, feeling emotionally stronger, and being able to relate more to others (20% increase average). 

What’s next for holistic health? We are continuously expanding the Community Health Advocates program, which includes the extension into the Wellvolution platform to assist members with Type 2 Diabetes. Additionally, we are ramping up technology to make members more connected to the health system beyond clinical measures, like receiving care at home.

We set out to recreate the system so that patients are at the center of it, which led to a need for high-tech, high-touch support – tools, time, and space to have meaningful medical visits and conversations. Accomplishments in this area included: 

  • mySidewalk: We have leaned on technology to help the work of our Community Health Advocates. In Fall 2020, we announced our
    the80 image
    collaboration with mySidewalk in creating the Neighborhood Health Dashboard, which was a tool we created together for the public to better understand the communities around them, and their social needs. The project led to the development of the80 and received a first-place Innovation Award from the Department of Health Care Services. 
  • Real-time claims: Technology advances in billing created transparency and choice for members, and alleviated administrative burdens for physicians in our real-time claims work. With help from OODA Health’s platform, and Dignity Health’s network, we took a two-hospital system in Sacramento to a statewide initiative servicing over 20 hospitals. 
  • Cricket Health: In 2020, we continued our at-home and telehealth care options for our members with late-stage chronic kidney disease through our collaboration with Cricket Health. Together, we were able to provide educational tools to give members choice in their treatment plan, as well as support from peers and a team of medical experts. 
  • Virtual transcription/consults and care: We added virtual transcriptions and virtual consults to get patients care quickly and safely amid the pandemic.

What’s next for high-tech, high-touch support? We are continuing to identify how to leverage technology to transform care so that it is more personalized for patients, eases the workload for physicians, and assesses and addresses social and systemic issues in a holistic manner. Among our pilot programs is one addressing Black maternal health through collaborations with tech companies and community organizations in the Sacramento and Los Angeles areas. Additionally, we have learned a great deal from testing solutions independently, which is resulting in us packaging them up in an integrated way. These customized solutions will maximize the impact of these offerings, which will continuously evolve to cater to needs of members, providers, and communities.

We’re using technology to improve personal care through these initiatives:

  • Health Information Exchange: While we have been working with Manifest MedEx for some time to establish a statewide health information exchange, our calls were addressed by Gov. Gavin Newsom in January 2021. 
  • Shared Decision-Making: We believe that patients have the right to feel empowered to choose their treatment plans. For these reasons, we started pilot programs with WiserCare to address birth plans for expecting mothers, and treatment plans and medication education for members with diabetes through Wellvolution
  • We launched Primary Care Reimagined in September 2020 to provide in-network physician groups access to an array of latest technologies to enhance their delivery of care, and new reimbursement models that provide more predictable cash flow for the physician practices, especially during the pandemic. And now, we are happy to announce that our initial participation goal of getting 100 practices signed up has been met, and exceeded. 

What’s next in personal care? Primary Care Reimagined will soon include even more providers in 2021, and we will continue to reimagine other areas of the system, including pharmacy care and behavioral health care. 

Peter Long is senior vice president and chief healthcare transformation and affordability officer at Blue Shield of California.