Health Plan Case Studies: A New Florida Blue

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, 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.

Kent Bottles, MD, is past-Vice President and Chief Medical Officer of Iowa Health System (a $2 billionhealth care organization with 23 hospitals). He was responsible for the day-to-day operations of a large education and research organization in Michigan prior to his work with in Iowa with IHS. Kent posts frequently at his blog, Kent Bottles Private Views.

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