11 Capital BlueCross is an Independent Licensee of the BlueCross BlueShield Association NOVEMBER, 5 2015 PAIU HUMAN RESOURCE AND BUSINESS MANAGERS FALL.

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Presentation transcript:

11 Capital BlueCross is an Independent Licensee of the BlueCross BlueShield Association NOVEMBER, PAIU HUMAN RESOURCE AND BUSINESS MANAGERS FALL MEETING

22 CAPITAL BLUE CROSS LOCAL SERVICE AREA Capital BlueCross Local Service Area

33 LEADING THE CHANGE Capital BlueCross’ mission is to improve the health and well-being of our customers and the communities in which they live.

444 MEDICAL VALUE = QUALITY. COST. SATISFACTION. Our Differentiating Medical Value Strategy OPTIMUM MEDICAL VALUE QualityCostSatisfaction ALIGNING INCENTIVES Consumer Engagement Provider Engagement Employer Engagement Solution Driver Examples: Value-Based Benefits Live Healthy Consumer tools Defined contribution options Capital Blue retail store Solution Driver Examples: Provider Service Organization Accountable Care Arrangements (ACAs) Consumer tools Data sharing Blue Distinction ® Centers Solution Driver Examples: Value-Based Benefits Live Healthy Consumer tools Comprehensive reporting Defined contribution options Medical Value = Quality. Cost. Customer Satisfaction.

555 Care Management Differentiators — Enhanced Collaboration Certified case managers and chronic care professionals Specialized and highly qualified team Trained in palliative medicine Intrinsic Coaching and Motivational Interviewing techniques Addressing Gaps in Care Collaborative care solutions to complex cases On-site, face-to-face services when necessary MEMBER OUTREACH AND ENGAGEMENT Capital BlueCross offers a full range of clinical programs to your employees.

666 HEALTH AND WELLNESS  Free, confidential, online health assessment tool PERSONAL PROFILE ONLINE DIGITAL COACHING  Free, online, interactive health coaching programs CONSULTATION SERVICES  Consultative support in building a culture of wellness with a dedicated implementation specialist 6

777 ONLINE MEMBER ENGAGEMENT TOOLS AND TECHNOLOGY Healthwise ® Knowledgebase The Blue365 ® program is brought to you by the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield Association is an association of independent, locally operated Blue Cross and/or Blue Shield Companies. Blue365 offers access to savings on health and wellness products and services and other interesting items that members may purchase from independent vendors, which are different from covered benefits under your policies with Capital BlueCross and its family of companies. On behalf of Capital BlueCross, Healthwise ® assists in the promotion of health and wellness by providing educational materials. Healthwise is an independent company.

88 MAXIMIZING THE VALUE OF YOUR HEALTH CARE DOLLARS Save Money While Staying Healthy *Cost comparisons are built from a historical range of amounts paid to providers. This is not a recommendation or endorsement of any particular health care provider or its service and should not be construed as medical advice. Capital BlueCross does not guarantee that services will be available or will be of any particular quality or cost. Apple, the Apple logo, iPad, iPhone, and iPod touch are trademarks of Apple Inc., registered in the U.S. and other countries. App Store is a service mark of Apple Inc. Ways to Save Alerts ® is a trademark of Change Healthcare Corporation. On behalf of Capital BlueCross, Change Healthcare Corporation provides health information content and member health platform tools. Change Healthcare Corporation is an independent company. Ways to Save ® is a helpful tool that shows our customers ways to save money on the health care services they use the most. It is simple. If there’s an opportunity to save money on office visits or treatments, we’ll send an -- a Ways to Save Alert ® -- with the details. Know the costs.* Make smart health care decisions. Start saving! If customers prefer text messages, they can follow these steps to get text alerts for savings: 1.Register or log in at capbluecross.com 2.Go to My Account and click Update My Communication Preferences 3.Add or verify mobile phone number 4.Check the Text Me box to turn on monthly Ways to Save text messages To opt out of and/or text alerts, uncheck the Ways to Save Me/Text Me boxes.

999 CUSTOMER CENTRIC SOLUTIONS  Face-to-face service  On-site care guides  Fitness demonstrations  Healthy-eating advice  Delicious, healthy food and beverages  Open enrollment meeting space Our Capital Blue retail store transforms your employees’ health insurance plan into an interactive, in-person health and wellness experience! Capital Blue is brought to you by Capital BlueCross, an Independent Licensee of the BlueCross BlueShield Association, serving 21 counties in central Pennsylvania and the Lehigh Valley.

10 DATA ANALYTICS The power of an advanced analytics platform to bring clarity to your health plan data. Theon Care Engager SM, imagined by Geneia, is designed to make the complex simple, giving you the ability to easily:  Make informed decisions  Visualize the most critical data  Streamline plan management  Identify care opportunities  Reduce waste and redundancy Theon SM is a product of Geneia ® LLC. On Behalf of Capital BlueCross, Geneia LLC provides health data informatics and analytical support and services. Geneia LLC is an independent company.

11 CAPITAL BLUE CROSS KEY DIFFERENTIATORS Capital BlueCross recognizes that to strengthen our foundation to support our customer and medical value focus, we must continue leading the way today, tomorrow, and for years to come. Tools Tools to guide customers toward higher quality care and providing the most cost effective way to meet each individual’s needs. Incentives Incentives to our members to increase health care engagement; incentives to providers for better care coordination and improvements in the overall quality of care. Partners Partnering with doctors and hospitals by providing accurate and timely data.

12 Capital BlueCross is an Independent Licensee of the BlueCross BlueShield Association Richard Migash Manager, New Business

13 Capital BlueCross is an Independent Licensee of the BlueCross BlueShield Association THANK YOU FOR YOUR TIME