Improving our Business to Raise Quality, Promote Affordability

Like many, I strongly believe that America’s doctors and hospitals offer unparalleled health care, including renowned centers of advanced learning and a technologically-enhanced system of care delivery.

But for far too many people, the difference between accessing great care and not getting the care you need is a matter of cost.

Affordability is undoubtedly the prevailing health policy issue of our time.

It’s an issue that we at Blue Cross Blue Shield of Michigan confront every day. It is critical to provide access to quality care for our members.

As a health insurer for 80 years, we’re proud that we’ve always accepted people with preexisting conditions, provided coverage in every county across our state, worked hard to expand Medicaid so everyone has access, and expanded our Medicare business to ensure access to quality care is always available.

We’re proud to deliver those valuable services. We pay an average of $68 million in insurance claims every day. To continue to provide the quality of service our members expect of us also requires cost management. And yet, a multitude of factors influence the cost of health insurance in America. The effectiveness and efficiency of our healthcare system is one.

We at Blue Cross Blue Shield of Michigan have good news in this regard.  We have worked with doctors and hospitals for 15 years to improve the quality of care and bring more value to our members and customers.

Together, this groundbreaking work has improved care, reduced complications and errors, and decreased unnecessary hospital stays and ER visits, preventing over $2 billion in health costs.

It has also made Michigan a national leader both in healthcare delivery and in restraining healthcare cost growth.  As a result, Blue Cross has kept our insurance rates very moderate – with a zero percent average premium increase for small employers since 2015, two straight reductions in our average Medicare Advantage premiums and the lowest rate adjustments for individuals in the history of the Affordable Care Act.

We know that the solutions to affordability that we all seek do not solely rest with us transforming healthcare delivery.  We must also do everything we can to keep our business operations running efficiently and effectively.

That’s why I championed an initiative at BCBSM to transform our business internally to create ongoing efficiencies and lower administrative costs while improving our products, service and processes. It’s part of a company-wide culture of Continuous Improvement. We call it Strategic Business Transformation.

Over the past three years, one of our signature programs to transform our business brought more than $360 million in value through projects that touched every corner of our company.

These big savings typically result from innovations delivered directly by the people who work in our business areas.  For instance, through a project to modernize our data storage, we enhanced data security and saved $1.8 million, while avoiding over $10 million in maintenance, license and software costs.  This is real savings, and it adds up to promote more affordable coverage for our members and a better company to manage their coverage.

Just by creating a faster, streamlined digital process to confirm enrollment of new members, we saved $2.2 million.  This helps our members in more ways than one.

I am proud of our company’s employees, and their ingenuity in delivering 160 projects that brought more value to our members, helped us reduce business costs and led to better member experiences.

And we’re not stopping there.

With the help of our Continuous Improvement team at BCBSM, we now have a sustainable set of capabilities to make our health care services perform smarter and better for our members, at lower cost.  This is an important internal change as we also look outward to work with providers, policymakers and others to confront the affordability challenge we face as an American healthcare system.

Leave a Comment

Your email address will not be published. Required fields are marked *