Blue Shield of California says its new custom Salesforce care management system will help it expand and scale more in-depth healthcare services to members and expand self-service options for employers to improve access to higher quality care.
WHY IT MATTERS
Blue Shield and Salesforce announced the expanded partnership, which leverages KPMG’s data expertise, to improve the flexibility of member services and streamline the end-to-end enrollment lifecycle, according to an announcement Wednesday.
The new clinical care management system, called Care Connect, combines data from 13 different systems, including clinical, laboratory, pharmacy, behavioral health, care gaps and other key sources of member health data.
“With a growing membership and increasingly complex medical cases, Blue Shield of California needs a holistic, unified view of its members to tailor care plans and address health challenges at every step of the care journey,” said Amit Khanna, senior vice president president and general manager. manager for health and life sciences at Salesforce, said in a statement.
Unifying membership data from multiple sources can help identify targets and interventions for better outcomes and lower costs, he added.
“Care Connect enables Blue Shield’s clinical care teams to better understand our members and deliver holistic care support through a new, integrated source of truth,” said Tracy Alvarez, vice president of medical care solutions at Blue Shield of California.
“This breakthrough technology has helped us reimagine how we deliver personalized and simplified healthcare experiences to our members.”
The partnership also created a single digital self-service experience for Blue Shield employers and brokers, according to the payer.
With the new automation capabilities, digital enrollment increased by 75% and manually reviewed group enrollment decreased by 50%, according to Blue Shield.
THE BIG TREND
Unifying health insights – from electronic health records, social and behavioral data, assessments and more – can also improve operational efficiency on the vendor side, according to Salesforce.
Earlier this year, the cloud provider released a number of real-time data and artificial intelligence integrations on Customer 360 for Health, including prior authorizations, intake and patient scheduling.
To support patients at home, at work or on the road, Salesforce also released more “care from anywhere” tools last year – remote patient monitoring, connected health, medication management and others.
“For years, the healthcare system has struggled to catch up to the innovation we saw in other industries,” Kevin Riley, SVP and general manager of healthcare and life sciences at Salesforce, said in a statement in 2022.
“But the pandemic forced us to accelerate digital transformation and equip the healthcare system with digital-first and always-available patient-centric solutions.”
In an email to Healthcare IT news About Blue Shield’s announcement, Khanna said that “care management and coordination are core elements to support health plans in improving outcomes,” and the company “will continue to improve this with our integrations into clinical guideline systems and health plans help address gaps in care to close effectively. .”
ON THE RECORD
“Our goal is to improve the way we interact with and care for our members during their interactions with Blue Shield of California and we now have a platform approach that allows us to create unified member experiences,” said Bill Giard, vice president of enterprise Blue Shield architecture. and health innovation, the announcement said.
Andrea Fox is editor-in-chief of Healthcare IT News.
Email: afox@himss.org
Healthcare IT News is a HIMSS Media publication.