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Health Equity, Interoperability, and Affordability: Highlights from the 2021 BlueCross BlueShield National Summit

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In a whirlwind nine-day virtual conference, the 2021 BlueCross BlueShied Summit featured significant focus on health equity, interoperability, and affordability as key issues that will shape the future of care. The Summit featured seven keynote sessions and more than 100 breakout sessions led by Blues leaders and partners.  

In her first Summit address as the Association’s CEO, Kim Keck was optimistic about the opportunities Blues plans have to innovate and lead meaningful change to our healthcare system, especially within the Medicare Advantage program. Currently covering 1 in 3 Americans and working with 95% of providers, the Blues collectively have significant potential to help address systemic racism in healthcare, according to Keck. 

Keck challenged attendees to reimagine healthcare in terms of delivery, integration, value, and quality.

Health Equity

Discussions of health equity spanned from member data collection and social determinants of health to employee culture and representation. In her opening remarks, Keck highlighted a specific goal of the association’s national health equity strategy: to reduce racial disparities in maternal health by 50% in 5 years. 

According to the CDC, “Black women are three times more likely to die from a pregnancy-related cause than White women.” Most of these deaths are preventable. This specific topic was the focus of a panel discussion featuring innovative work by Horizon Blue Cross Blue Shield of New Jersey, BlueCross BlueShield of South Carolina, and Blue Cross Blue Shield of Michigan. Leaders from these plans presented programs aimed at reducing c-sections and improving infant health, with a focus on  group-based prenatal care and support. 

After the Summit, the Association released its report on Racial Disparities in Maternal Health. The report breaks down data for the risk of severe maternal morbidity and includes survey responses from Black, white, and Hispanic mothers about healthcare perceptions. 

Interoperability and Integrated Care

Interoperability was also a key topic in support of social determinants of health (SDOH) and health equity goals. Keck highlighted data collection as the core of the Association’s health equity strategy. As part of this initiative, the Association is participating in The Gravity Project, a HL7 program tackling the standardization and visibility of SDOH data on a global scale. 

In the rapidly changing marketplace, the Blues look toward omni-channel care delivery to meet patients’ growing expectations. Several sessions focused on the integration of behavioral and mental healthcare as well as  permanent telehealth programs. Many Blues plans have already been leading the way with expanding access to telemedicine. 

Affordability

Significant conference attention was also devoted to the topic of healthcare affordability and what can be done to curtail continuously rising costs. According to CMS, under current law, healthcare expenditures will continue to outpace inflation for the foreseeable future. One session noted that the current cost of a family health insurance plan is now more than the cost of a new Honda Civic. 

In a poll during the opening keynote, 41% of respondents selected “Affordability” as the number  one “force shaping healthcare today that will have the most impact as the Blues lead into the future.” Discussions of how to address rising costs focused on approaches favoring fee-for-service price caps, price growth caps, and flexible oversight. Some sessions noted that broader systemic reforms like a public option were not considered likely during the Biden administration.

Regarding the impact of transparency on overall cost, experts warned attendees not to think of  price transparency as a magic wand. “Current transparency requirements put too much onus on the least powerful party in healthcare transactions: the patients,” said Niall Brennan, President and CEO, Health Care Cost Institute.

There were also several calls for the federal government to address prescription drug spend, which is projected to cost $850B by 2022.

There’s not one one solution that will make the U.S. healthcare system more affordable and more equitable for all. However, as presented throughout the Summit over the last couple of weeks, Blues plans are committed to increasing interoperability, decreasing healthcare costs, and improving healthcare quality for all Americans. 

On top of the commitments highlighted during the Summit, Blues plans shouldn’t have to worry about fraud, waste, and abuse in their networks, which typically takes significant resources to combat. ProviderTrust offers a proactive approach to provider network eligibility, which helps payers improve their efficiency and increase profitability within their government programs, reduce the risk of ineligible claims, and improve interoperability across functional teams.

It's time for smarter provider network monitoring.

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