“Show of hands — how many people feel the average American consumer is doing reasonably well with the healthcare system overall?” asked Blue Shield of California president and CEO Paul Markovich during his presentation at the J.P. Morgan Healthcare Conference in San Francisco last week.
Markovich took the stage for a 25-minute discussion and Q&A with leading healthcare executives.
The question that Markovich posed to the crowd was answered by no more than two raised hands.
“That gap is what this talk is all about,” Markovich said. “I submit to you that none of us, in the long term, can be successful in our organizations if the system itself is fundamentally failing Americans in this country — and it is.”
With that, Markovich kicked off his discussion on Blue Shield of California’s priorities to address the issues plaguing our healthcare system in 2024 and beyond. He opened by sharing what he believes to be two fundamental reasons for the industry’s deficiencies:
- Health care is unaffordable, and prices continue to rise at astronomical rates.
- The healthcare system is deeply unpopular in this country, and only becoming more so.
“We are going to hit a tipping point,” Markovich said. “The fundamental question that will be asked: Are you a part of the problem, or are you a part of the solution?”
The U.S. healthcare system can be fixed. Blue Shield of California is leading the way to overcome intractable problems in the industry.
Bring healthcare into the digital age
Members and clinicians need to have a healthcare experience that operates just as smoothly as the other services they rely on in their lives, from grocery delivery to online shopping.
Blue Shield of California has done this by releasing an app that gives members access to 100% of their personalized health records — all in one place. Blue Shield of California partnered with Microsoft and Salesforce to develop this platform, making healthcare easier, simpler and more accessible for members.
Tie pay to value
We need to make sure major players are rewarded for making health care more affordable and higher quality.
This year, more than half of our primary care physicians will participate in a value-based care arrangement, and we’re seeing results. Healthcare costs dropped 10% among providers participating in the model.
Along with this, the Blue Shield of California Wellvolution platform, which includes digital tools for members in weight management, diabetes and mental health, is proving that paying for outcomes is indeed a sustainable model. Wellvolution providers are helping members live healthier lives and overcome chronic conditions.
Make prescription drugs accessible and affordable
The pharmacy system is a poster child for an industry that doesn’t tie pay to value.
There’s currently a system of eight players involved in getting a drug to a patient, and all of them make more money when we sell a higher volume of more expensive drugs.
To fix this system, Blue Shield of California’s new approach, Pharmacy Care Reimagined, goes directly to the pharmaceutical manufacturers to cut out the extra costs. The model was developed through partnerships with other like-minded companies committed to reforming this system, including Mark Cuban’s Cost Plus Drug Company and Amazon Pharmacy.
These partners will be reimbursed for getting members their medications efficiently and affordably.
Personalize a holistic patient experience
Health care needs to be high-tech, but it also needs to be high-touch.
Blue Shield of California relies on community health advocates to reach members who face barriers to accessing healthcare services. These advocates work to understand and address socio-economic factors that impact the health of our members, whether it’s accessing transportation to get to appointments on time, a technology issue or even an issue in the home.
Markovich’s presentation showcased that Blue Shield of California is unafraid to challenge the status quo of health care, and we’re excited to lead the way on initiatives that are making health care work better for all of us.
