What’s the Member and Employer Experience Like?

Great ideas don’t land if they’re not well executed. See Blue Shield in action.

It’s a digital world. <br>People expect health care to deliver a consumer-like experience, and Blue Shield is bringing it.

  • More personalized care options

    There are now more ways for members to get care when and how they want: digital first, telehealth, virtual appointments, in-person care, and in-home care. Our coming virtual-first plan will feature primary, specialty, and mental health care in a virtual environment.

  • More behavioral health options

    New options include Teladoc(R) mental health appointments, the Brightline program for children and teens (reducing wait times from 6 months to 24 hours), and shatterproof substance abuse treatment. We are also embedding behavioral health in pilot programs, and our Wellvolution(R) suite of lifestyle medicine apps, now including Ginger and Headspace.

  • More community-based care

    With innovative pilots and partnerships, we’re getting members the services they need, closing care gaps in the process. Programs include our community health advocates, who connect members with social services and other programs that reduce barriers to care, walk-in health support at Walgreens Health Corners, and other health advisory and outreach programs.

  • Primary Care Reimagined

    Members can look forward to real-time claims, which we’re piloting in several practices through a partnership with Google. The checkout experience for members is quick and simple while allowing medical offices to reduce time spent on paperwork by 2.5 fewer hours a day. eTranscription services let doctors focus on patients instead of inputting data. New, bundled payment models make time-consuming individual claims a thing of the past for chronic care needs. And these are just the beginning.

Connect: High-touch customer service, personalized care management.

  • ShowHide Transcript

    Paula Lunde ( 00:08 ):

    Healthcare can be scary and it can also be complicated. We help members navigate a system that isn't always easy to best meet their needs. We've got end-to-end clinical solutions that can address members' needs, whether they're a low utilizer who's fairly healthy, or if they become moderate utilizers, just making sure that all of our medical management services are meeting everyone's needs. Clients who are on our Connect model are seeing two to three times the engagement that we see with some of our other care models, and then we're realizing cost savings as a result. We have a multidisciplinary care team that's made up of registered nurses, behavioral health clinicians, dieticians, health coaches, community health advocates.

    Betheina "Beth" Fernandez ( 00:54 ):

    It's really the 360 approach. We're able to reach out to our pharmacists and they'll let us know what we need. We can then turn that around and speak with a member. We can reach out to the doctors and really be there hand-in-hand like we're supposed to be.

    Sabina Rosenstock ( 01:10 ):

    When we support our members, we do our best to send them as much information as we can to reduce any homework that they might need to do on their own. A recent member that I worked with had a new diagnosis of cancer. We were able to discover that they could really use some extra emotional support. So I was able to connect them with a personal therapist as well as a cancer support group, and then also connect them with our registered nurse case managers to assist him with some referrals and authorizations to be able to coordinate with his providers and his treatment team.

    Betheina "Beth" Fernandez ( 01:39 ):

    We go that extra mile. We want to make sure that the member is never going to hear a no from us. Every aspect of the programs are designed to show the employees how much the employer cares about their wellbeing.

    Sabina Rosenstock ( 01:56 ):

    I really appreciate our team approach to helping members, and hearing the feedback from members has been really wonderful.

    Betheina "Beth" Fernandez ( 02:04 ):

    While I'm on duty and while I'm on the phone, I feel like a hero.

    Paula Lunde ( 02:08 ):

    We're proud of how our teams have really touched the lives of members and really improved the quality of life.

  • Members only need to know one place to go: Blue Shield Connect. Here, they can get answers or help with anything; most member needs are met on the first call. We also back our concierge-style service with performance guarantees.

    Connect gives our support teams a 360-degree view of a member’s plan and health needs.

    Specially trained customer service reps answer benefits questions, including claims questions.

    A clinical care management team (including RNs and pharmacy support) works directly with each member for care-related issues.

    Our predictive recommendations engine enables targeted outreach to members, leading to a healthier workforce.

    • Excellence in Customer Service Award 2021

      In 2021, Business Intelligence recognized us for Excellence in Customer Satisfaction

    • 4 Star overall customer satisfaction

      In a 2020 survey by insure.com, Blue Shield was named #1 in Member Satisfaction for Claims Processing

  • Wellvolution: The lifestyle medicine program that delivers choice—and life-changing results

    Wellvolution is a curated collection of nearly 60 therapeutic apps, addressing areas ranging from obesity and diabetes to behavioral health. These lifestyle medicine programs are scientifically validated and address the root cause of health issues, leading to real change and long-term improvement, and lowered healthcare spending over time—all at no cost to members.

    • 57 billion

      steps walked by Wellvolution members

    • 15,784

      pounds lost by members since 2017

    • $1.6 million

      saved by members who quit smoking

  • Health Reimagined: How we’re leading on change

    Changing a complex health system takes commitment. Blue Shield is all in. We’re reimagining care to make it more accessible, more affordable, and simpler for everyone.

    That includes building a modern health ecosystem that makes “anytime, anywhere” care not just possible but seamless. It means addressing rising costs; for instance, how payments move through the healthcare system or how we can help control the cost of prescription drugs. And it means a shift in focus to healthier outcomes for all.

  • For employers: A proactive, responsive partner

    We help you meet cost containment and employee engagement objectives, including working with you to optimize plan performance. Support options may include the following:

    Nimble account management: National and large group accounts are served by seasoned account managers who typically have 10 to 20 years' experience.

    Intelligent Health reporting: A user-friendly dashboard with real-time data on utilization; the ability to benchmark your company compared to national, regional, and industry competitors; and more.

    Superior self-service options: Small businesses have a range of digital tools available, including microsite and PDF enrollment kits.

Want to talk? Contact us to discuss your needs.