Health Plans Receptive, But Not Ready for Change
HLM: At some point, the health insurance industry will have to react, what do you think has to happen to catalyze their response?
Phillips: This is a particular challenge for Blue plans. We have to get into a posture where we can pilot quickly and fail quickly. We also have to be willing to come back around when we see modifications developed in the market that we can redeploy if they didn't work the first time.
A good example of that is disease management. We've had some effect on controlling costs, but not the effect that we wanted. If we tie disease management to the technology that was talked about, then we have another way of monitoring and engaging with the patient where we might actually be able to change the cost curve.
It would be incumbent upon the payer community to say, ‘I know the investment in disease management didn't go so well, but we may have been in that space before we had the capability to move the needle,' and telehealth is another example of that.
HLM: Is BCBS TN's partnership with MissionPoint ACO, which has reported some early success with telehealth initiatives in rural areas, helping posture the company to make inroads on disease management and telehealth?
Phillips: Yes. We have to reformulate the way we think about things, and that's a good example of choosing a partner who can pivot quicker than we can. Our claims systems, [and] our payments systems are not necessarily designed to do that.
- Top Reason for Nurse Turnover: Managers
- CEO Exchange: Pressure is On to Partner, Drive Quality
- Interventional Radiology No Longer a Sub-Specialty
- Behind the CVS Health Rebranding Strategy
- CMS Pitches Medicare Appeals Deal to Hospitals
- How MA plans to re-enroll 450,000 residents in health insurance
- Mobile Health Screenings Come Under Scrutiny
- House OKs Cassidy's 'keep your plan' bill
- Medicare is pricier in unhealthy states, study says
- Strategically, Physicians Make Room for RNs