Top 6 Challenges for Blue Cross Blue Shield Association Member Companies in 2017

2016 has brought many challenges to the health industry. Difficulties with reimbursements and increases in medical costs has driven up the bottom line. Additionally, significant increases in funding of digital health startups over the past three years have brought an onslaught of companies disrupting segments of the payer business model. Fortunately, the Blue Cross Blue Shield brand is a household name that can carry member companies into Health 2.0.

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Over the past 15 years we have been working in digital health, including with BCBSA member companies. Based on our observations here are the six areas BCBSA member companies will be focusing on in 2017:

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Alternatives to Traditional Insurance:  Aligning the Accrual of Benefits

The healthcare delivery system is undergoing tremendous change because of pressures to increase access, reduce costs and improve outcomes.  New and innovative approaches to how care is being delivered are emerging and the shift to population health, along with an emphasis in engaging patients in self-management activities, are all contributing to the transformation of healthcare in the United States.

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11 Patient-Centered Digital Health Trends in 2016

Today’s healthcare leaders are faced with challenges in managing the financial health of their organizations; especially in response to the expansion of quality reporting, meaningful use and other penalties.  They are looking for ways to improve the health of their patients, and condition-specific populations, at a reasonable cost.  Increasingly they hear about the importance of patient-centeredness and the most effective of these leaders are recognizing the connection to digital health tools.

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EHR Integration – Challenges and Solutions

The marriage between a hospital and its electronic medical records vendor may not always be loving and open, and may even end in divorce. But while the relationship is flourishing, the pair are by necessity devoted to one another, and the vendor often tries valiantly to meet its hospital’s every need, in every department.

So why would a big, dominant EHR vendor like EPIC or Cerner allow an interloper into the family…  some young thing fresh from Santa Clara or Madison or Austin, offering a new and exciting way to solve some small part of the hospital’s complicated life? Because they have to.

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Exchanges 3.0? How health insurance marketplaces are evolving

Consumers are buying health insurance in new ways these days, while still turning to in-person help for making a choice — even in the age of the online economy.

The end of January brought the end of open enrollment for the third year of the exchanges, a key part of the Affordable Care Act. It’s been a rocky trip for all involved, especially consumers, many of whom were digital-savvy purchasers of all kinds of goods and services before the ACA.

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Why Consumer Success Depends On Business Processes 2/2

3 things to know about the future of provider networks and partnerships

Along with consumers who increasingly have a choice of insurance, a health plan’s business processes can impact the kinds of providers they attract, setting the stage for future relationships in the new alternative payment, value-based world.

Primary care practitioners and specialists may be leery of investing their time and money in new value-based contracts if there is not some indication that it will be easier for them to take new patients, get paid regularly, ask questions and reasonably adjudicate payments for disputed treatments.

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Why Consumer Success Depends On Business Processes 1/2

Navigating consumers: The hidden technology metric

Healthcare is changing, but health insurers need to change faster in some underappreciated areas to prepare for the most monumental shifts. Here’s what we know and what we don’t about the consumer imperative.

Though removed from health plan customers in some ways, as they experience it, modern, sustainable business processes and IT are necessary for convenient, quality healthcare—and for insurers to keep their business.Today, in the new healthcare economy, business processes are becoming a metric for the patient and health plan member experience.

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