Dr. Nina Birnbaum is medical director of Innovation Acceleration at Blue Shield of California and has been with the company for over two years. Nina and her team recently launched Virtual Blue, the “virtual-first” preferred provider organization (PPO) plan that allows members to choose their network of doctors and specialists whom they can see virtually or in-person, without the need for referrals.
Have you always worked in health care?
Yes. I decided I wanted to go to medical school during my senior year of high school, found primary care in my first year of medical school, and never looked back. I eventually had the opportunity to lead a team of 60 or so physicians and I loved it! I loved hiring and managing people, getting teams to focus on quality, and figuring out how to make the patient experience better.
What brought you to Blue Shield?
When I saw my job on LinkedIn, it was so appealing because it took what I had been doing and made it bigger. I went from a team serving around 80,000 patients to being able to impact almost five million patients. It felt like a very exciting opportunity to take what I knew and expand the impact.
What is a recent, transformative accomplishment made by your team?
The biggest triumph we have had is the launch of Virtual Blue, our new virtual health plan, which hit the market in January 2023. What is exciting to me is that Virtual Blue is "virtual first" but members are never alone. That's because the plan is strongly based on the advanced primary care model, which gives our members more control of their care, with a virtual care team guiding them through the healthcare system. Virtual Blue integrates behavioral health, primary care, and specialty care so that it is not disjointed. It also eliminates geography as a barrier to accessing care. When we piloted it to Blue Shield employees during open enrollment this year, we had great growth from our base PPO plan.
How has Virtual Blue impacted those who did not have access to these services before?
We received some deeply meaningful comments when we asked, ‘What would you do if we no longer offer Virtual Blue?’ One Blue Shield member who lives in a rural area said he would have to go back to driving hours to see his doctor. Another member who was struggling with complex symptoms and had not yet found the right specialist was able to receive a diagnosis and a treatment plan faster than if she had been seeking out in-person care.
We also had a patient with high blood pressure who could not get to the doctor because she was caring for a family member. The virtual care model allowed her to not only receive treatment for her high blood pressure, but also determined she was experiencing stress and depression and received behavioral health care linked into her primary care without having to leave the family member alone.
What would you say is the most exciting thing about the future of health care?
We are gaining the capability to process huge amounts of data quickly. I think at the macro level, it will enable us to look across an entire population and see where the problems are and bring resources to target their needs. On the individual level, you can look at a person’s data in a deep way and move towards personalization of their treatment and overall care. I think artificial intelligence (AI) is going to quickly change how people interact with health care by taking the burden of documentation and differential diagnosis off doctors and nurses. This makes the process less stressful and more human, as practitioners can focus more on engaging with patients.